Malia Lynn Johnson, DDS in Nipomo, CA - Medicare Dentist Provider

Malia Lynn Johnson, DDS is a medicare enrolled "Dentist" provider in Nipomo, California. Her current practice location is 150 Tejas Pl, Nipomo, California. You can reach out to her office (for appointments etc.) via phone at (805) 929-3254.

Malia Lynn Johnson is licensed to practice in California (license number 54498) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679771174.

Contact Information

	Malia Lynn Johnson, DDS
	150 Tejas Pl, Nipomo, CA 93444-9123
	(805) 929-3254
	(805) 929-6440

Healthcare Provider's Profile

Full Name	Malia Lynn Johnson
Gender	Female
Speciality	Dentist
Location	150 Tejas Pl, Nipomo, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679771174
Provider Enumeration Date: 07/05/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 2961636931
Enrollment ID: I20131004000402

Medical Identifiers

Medical identifiers for Malia Lynn Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679771174	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	54498 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Malia Lynn Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Malia Lynn Johnson, DDS 150 Tejas Pl, Po Box 430, Nipomo, CA 93444-9123 Ph: (805) 931-2556	Malia Lynn Johnson, DDS 150 Tejas Pl, Nipomo, CA 93444-9123 Ph: (805) 929-3254

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Dentist in Nipomo, CA

Dr. Edward Shapiro, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 530 W Tefft St, Nipomo, CA 93444 Phone: 805-929-6814 Fax: 805-929-2074
Dr. Raj Bhupendra Lotwala, DDS Dentist Medicare: Medicare Enrolled Practice Location: 150 Tejas Pl, Nipomo, CA 93444 Phone: 805-931-2653
Joseph Rocco Mercardante Jr., Dentist Medicare: Not Enrolled in Medicare Practice Location: 150 Tejas Pl, Nipomo, CA 93444 Phone: 805-938-0935
Dr. Emily Renk Hawthorne, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 150 Tejas Pl, Nipomo, CA 93444 Phone: 805-929-3211
Trey Stephen Jangaard, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 150 Tejas Pl, Nipomo, CA 93444 Phone: 805-931-2728 Fax: 805-931-2737
Paul A Walker, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 150 Tejas Pl, Nipomo, CA 93444 Phone: 805-929-3254 Fax: 805-929-6440
Jennifer Phuong Chung, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 150 Tejas Pl, Nipomo, CA 93444 Phone: 805-929-3254 Fax: 805-931-2569

Malia Lynn Johnson, DDS - Medicare Dentist in Nipomo, CA