Healthcare Provider Details

I. General information

NPI: 1215747720
Provider Name (Legal Business Name): AARON JOHNSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3572 LELAND TOWN CENTER DR STE 140
LELAND NC
28451-0680
US

IV. Provider business mailing address

3572 LELAND TOWN CENTER DR STE 140
LELAND NC
28451-0680
US

V. Phone/Fax

Practice location:
  • Phone: 910-994-6557
  • Fax:
Mailing address:
  • Phone: 910-994-6557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14207
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: