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General NPI Number Information
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NPI Number | 1902627540
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Entity Type | Organization
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Legal Business Name | SAMANTHA L. JOHNSON DMD LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 4007 VALLEY VIEW DR
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City | LOUISVILLE
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State | KY
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Zip | 40216-4221
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Country | US
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Telephone | 502-448-0678
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Fax |
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Provider Business Mailing Address
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Address Line | 4007 VALLEY VIEW DR
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City | LOUISVILLE
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State | KY
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Zip | 40216-4221
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Country | US
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Telephone | 502-448-0678
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMANTHA L JOHNSON
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Credential | DMD
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Telephone | 502-448-0678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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