TRAVIS ALLAN JOHNSON (D.D.S.) – Oral and Maxillofacial Surgery (Dentist), NPI 1841637295
Oral and Maxillofacial Surgery (Dentist)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
81 ORAL SURGERY in MN
Provider Addresses for TRAVIS ALLAN JOHNSON (D.D.S.)
750 Main St Ste 203
Mendota Heights, MN 551183767
Phone: (651) 451-1873
Type: Location
1420 Lake St S Ste 200
Forest Lake, MN 550252713
Phone: (651) 578-7000
Type: Location
1560 Beam Ave Ste E
Maplewood, MN 551091171
Phone: (651) 578-7000
Type: Location
9950 VALLEY CREEK RD STE 100
WOODBURY, MN 551255803
Phone: (651) 578-7000
Fax: (651) 578-0157
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $77.
Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Envista Holdings Corporation ($50).
Total Amount
$77
General + Research + Ownership
Payments
2
Total payment records
General Amount
$77
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Envista Holdings Corporation | $50 |
| Dentsply Sirona Inc | $27 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-05-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200504000200 | I | Oral Surgery | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 55118)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Oral Surgery, Maxillofacial Surgery | MN |
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