Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1437292570 Individual Practitioner Female Practitioner

Dr. Mary Beth Johnson , DDS

Dentist - General Practice • Polacca, AZ

Professional Overview & Biography Verified Profile Summary

Dr. Mary Johnson, DDS is a registered healthcare professional specializing in Dentist - General Practice in Polacca, AZ. Practice services are available at HWY 264, MP 388 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

Hwy 264, Mp 388

Polacca, AZ 86042

Telephone 9287376162

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Polacca, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.4 Yrs
Regional Practice Density
3 Specialists

Practicing in Polacca, AZ (2600 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OH 30020478

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - Pediatric Dentistry

NUCC Taxonomy Code: 1223P0221X

State License OH 30-020478

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
420456 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Ruth Williams , RDH

Dental Hygienist

NPI 1396075198

Registered Dental Hygienist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 26, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location June 26, 2009

Registered at HWY 264, MP 388, POLACCA, AZ 86042 (Tel: 9287376162)

📍
Updated Business Mailing Address June 26, 2009

Registered at HOPI HEALTH CARE CENTER KEAMS CANYON S.U., PO BOX 4000, POLACCA, AZ 86042

👤
Provider Name / Credentials Updated June 26, 2009

Recorded as MARY JOHNSON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2009

Dentist (License #30020478 in OH)

🟢
Initial NPI Registration & Enumeration February 15, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1437292570
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 15, 2007
Last Update: June 26, 2009
Sole Proprietor: No

Mailing Address

Hopi Health Care Center Keams Canyon S.u., Po Box 4000

Polacca, AZ 86042

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.