Dr Shannon Polly Johnson, DMD in Louisville, KY

Dr Shannon Polly Johnson, DMD is a medicare enrolled "Dentist" provider in Louisville, Kentucky. Her current practice location is 9510 Ormsby Station Rd Ste 203, Louisville, Kentucky. You can reach out to her office (for appointments etc.) via phone at (028) 050-5005.

Dr Shannon Polly Johnson is licensed to practice in Kentucky (license number 7939) 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 1598975971.

Contact Information

	Dr Shannon Polly Johnson, DMD
	9510 Ormsby Station Rd Ste 203, Louisville, KY 40223-4083
	(028) 050-5005
	(502) 771-6041

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Shannon Polly Johnson
Gender	Female
Speciality	Dentist
Location	9510 Ormsby Station Rd Ste 203, Louisville, Kentucky
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598975971
Provider Enumeration Date: 05/23/2007
Last Update Date: 02/08/2022

Medicare PECOS Information:

PECOS PAC ID: 0345436481
Enrollment ID: I20160524000234

Medical Identifiers

Medical identifiers for Dr Shannon Polly Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598975971	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DN 17245 (Florida)	Secondary
122300000X	Dentist	7939 (Kentucky)	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. Dr Shannon Polly 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
Dr Shannon Polly Johnson, DMD 2913 Creekside Dr, Louisville, KY 40241-2106 Ph: (502) 957-9390	Dr Shannon Polly Johnson, DMD 9510 Ormsby Station Rd Ste 203, Louisville, KY 40223-4083 Ph: (028) 050-5005

Reviews and Comments

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Dr Shannon Polly Johnson, DMD - Medicare Dentist in Louisville, KY