Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1467431932 Individual Practitioner Female Practitioner

Dr. Kelly Wade Johnson , DDS

Dentist - General Practice • Lansing, MI

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Johnson, DDS is a registered healthcare professional specializing in Dentist - General Practice in Lansing, MI. Practice services are available at 2815 S PENNSYLVANIA AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2815 S Pennsylvania Ave
#203

Lansing, MI 489103495

Telephone 5172724150
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Lansing, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.8 Yrs
Regional Practice Density
92 Specialists

Practicing in Lansing, MI (4360 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 MI 2901018145

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
4530810 (MI)
Commercial Insurance / Payer ID United Concordia
1385419 (MI)
Commercial Insurance / Payer ID Delta Dental
161661900 (MI)
Commercial Insurance / Payer ID Blue Cross Blue Shield
161661900 (MI)

Practice Associates & Co-Workers

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

3 Associated Practitioners
Jessica Snow , DH

Dental Hygienist

NPI 1194156562
NPI 1407049810

Doctor of Dental Surgery

Connie Compton , RDH

Dental Hygienist

NPI 1417382847

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 September 10, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 10, 2015

Registered at 2815 S PENNSYLVANIA AVE, #203, LANSING, MI 489103495 (Tel: 5172724150)

📍
Updated Business Mailing Address September 10, 2015

Registered at 5303 S CEDAR ST, LANSING, MI 489113800 (Tel: 5172724150)

👤
Provider Name / Credentials Updated September 10, 2015

Recorded as KELLY JOHNSON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2015

Dentist (License #2901018145 in MI)

🟢
Initial NPI Registration & Enumeration January 12, 2006

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: 1467431932
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 12, 2006
Last Update: September 10, 2015
Sole Proprietor: No

Mailing Address

5303 S Cedar St

Lansing, MI 489113800

Phone: 5172724150

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.