Johnson, Gina B.
Johnson, Gina B. is an individual health care provider with primary practice located at 2230 Towne Lake Parkway Bldg 1300, Ste 100, Woodstock GA 30189. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dental Public Health, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Johnson, Gina B. can be contacted via phone (678) 445-5444.Contact Information
Primary practice address
2230 Towne Lake Parkway Bldg 1300, Ste 100
Woodstock GA 30189
Phone: (678) 445-5444
Fax: (678) 445-5552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Public Health | 1223D0001X | DN011762 | Georgia |
| Dental Providers / General Practice | 1223G0001X | DN011762 | Georgia |
Profile Details
| NPI number | 1689716839 |
|---|---|
| LBN Legal business name | Johnson, Gina B. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Aug 30th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689716839 | NPPES |
| Georgia | Other | 9210146 | DORAL DENTAL |
| Georgia | Other | 102101 | DORAL DENTAL |
| Georgia | MEDICAID | 9980277608B | DORAL DENTAL |
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