Healthcare Provider Details

I. General information

NPI: 1659253508
Provider Name (Legal Business Name): SARAH ANNE JOHNSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 CROMWELL PARK DR STE 108
GLEN BURNIE MD
21061-3245
US

IV. Provider business mailing address

920 CROMWELL PARK DR STE 108
GLEN BURNIE MD
21061-3245
US

V. Phone/Fax

Practice location:
  • Phone: 410-760-5120
  • Fax:
Mailing address:
  • Phone: 410-760-5120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number18889
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18889
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: