=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285558437
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHNSON ORAL SURGERY KNOXVILLE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2026
-----------------------------------------------------
Last Update Date | 08/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10025 INVESTMENT DR STE 140
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37932-2664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-364-1122
-----------------------------------------------------
Fax | 865-364-1234
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10025 INVESTMENT DR STE 140
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37932-2664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-364-1122
-----------------------------------------------------
Fax | 865-364-1234
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. BENJAMIN WINGAITE JOHNSON
-----------------------------------------------------
Credential | DDS, FACS
-----------------------------------------------------
Telephone | 865-771-0818
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------