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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689716839 NPPES
Georgia Other 9210146 DORAL DENTAL
Georgia Other 102101 DORAL DENTAL
Georgia MEDICAID 9980277608B DORAL DENTAL

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