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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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 1114921491 NPPES
South Carolina MEDICAID Z31163

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