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General NPI Number Information
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NPI Number | 1104752369
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Entity Type | Individual
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Provider Name | SAMANTHA CLAIRE JOHNSON DMD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 1848 GREAT HAMMOCK BND
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City | FREEPORT
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State | FL
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Zip | 32439-6695
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Country | US
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Telephone | 850-953-7005
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Fax |
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Provider Business Mailing Address
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Address Line | 704 MARCIA CIR
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City | MARY ESTHER
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State | FL
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Zip | 32569-2014
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Country | US
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Telephone | 678-758-3310
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Fax |
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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 | DN32057
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License Number State | FL
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