Healthcare Provider Details

I. General information

NPI: 1841155025
Provider Name (Legal Business Name): ROOTLINE ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 CHEROKEE ST NE
MARIETTA GA
30060-1349
US

IV. Provider business mailing address

591 CHEROKEE ST NE
MARIETTA GA
30060-1349
US

V. Phone/Fax

Practice location:
  • Phone: 770-794-7117
  • Fax:
Mailing address:
  • Phone: 770-794-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIAN A.H JOHNSON
Title or Position: ENDODONTIST
Credential: DMD
Phone: 770-794-7117