Healthcare Provider Details

I. General information

NPI: 1235164781
Provider Name (Legal Business Name): JULIA M ONEIL-JOHNSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 E MAIN ST
COLUMBUS OH
43205-1902
US

IV. Provider business mailing address

2780 AIRPORT DR STE 100
COLUMBUS OH
43219-2289
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-5535
  • Fax: 614-645-5546
Mailing address:
  • Phone: 614-859-1906
  • Fax: 614-458-1849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number19775
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: