Johnson, Karen Evangeline
Johnson, Karen Evangeline is an individual health care provider with primary practice located at 2757 Laurel St Ste 1 , Columbia SC 29204-2037. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Johnson, Karen Evangeline can be contacted via phone (803) 606-9011.Contact Information
Primary practice address
2757 Laurel St Ste 1
Columbia SC 29204-2037
Phone: (803) 606-9011
Fax: (803) 630-1529
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 11759 | Maryland |
| Dental Providers / Periodontics | 1223P0300X | 3116/PERIO 470 | South Carolina |
Profile Details
| NPI number | 1114921491 |
|---|---|
| LBN Legal business name | Johnson, Karen Evangeline |
| Credentials | DDS, MHS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2005 |
| Last updated | Oct 10th, 2023 - about 3 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 | 1114921491 | NPPES |
| South Carolina | MEDICAID | Z31163 |
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