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General NPI Number Information
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NPI Number | 1073681292
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Entity Type | Individual
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Provider Name | CARROLL ARTHUR JOHNSTON DDS
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 150 ELDEN ST SUITE 200
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City | HERNDON
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State | VA
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Zip | 20170
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Country | US
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Telephone | 703-707-2070
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Fax | 703-707-0450
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Provider Business Mailing Address
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Address Line | 13435 MIDLANDS FARM LN
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City | LOVETTSVILLE
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State | VA
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Zip | 20180
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Country | US
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Telephone | 540-882-4168
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Fax | 540-882-4768
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401411364
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5964
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License Number State | MD
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