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Maxine Johnson , DA

Dental Assistant • Gallup, NM

Active NPI 1508015199 Individual Practitioner Female Practitioner
Practice location in NPPES

516 Nizhoni Blvd
Gallup, NM 873015748

Call 5057221000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

516 Nizhoni Blvd

Gallup, NM 873015748

Telephone 5057221000
Fax 5057221565
Organization at the Same NPPES Address or Phone
Gallup Indian Medical Center Facility NPI 1285811208

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2008

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gallup and New Mexico

25 active clinicians are listed under Dental Assistant with a practice address in Gallup, NM (31 in New Mexico).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gallup

0% of these 25 clinicians have the CMS telehealth indicator.

0% of these 25 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Dental Assistant Primary Specialty

NUCC Taxonomy Code: 126800000X

An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: New Mexico State Medical Licensing Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
NPI 1376790725

Doctor of Dental Surgery

NPI 1003590886

Doctor of Optometry

Dr. Angela Dorsey , DO

Family Medicine

NPI 1033308341

Doctor of Osteopathic Medicine (D.O.)

NPI 1063449577

Doctor of Dental Surgery

Dr. James Sidd , DDS

Dentist - General Practice

NPI 1306860234

Doctor of Dental Surgery

Career & Practice History

NPI enumerated September 18, 2008.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.

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NPI Administrative Meta

NPI Number: 1508015199
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 18, 2008
Last Update: September 18, 2008
Sole Proprietor: No

Mailing Address

Po Box 1337

Gallup, NM 873051337

Phone: 5057221000

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.