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General NPI Number Information
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NPI Number | 1952538092
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Entity Type | Individual
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Provider Name | BENJAMIN WINGAITE JOHNSON DDS, FACS
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Gender | Male
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 60 N MERRIMON AVE
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City | ASHEVILLE
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State | NC
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Zip | 28804-1391
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Country | US
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Telephone | 865-771-0818
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Fax |
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Provider Business Mailing Address
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Address Line | 60 N MERRIMON AVE UNIT 107
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City | ASHEVILLE
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State | NC
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Zip | 28804-1392
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Country | US
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Telephone | 865-771-0818
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 13073
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 10176
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License Number State | AZ
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