Provider Demographics
NPI:1164442653
Name:JOHNSTON, MARGARET (OD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:PLACENTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:7405 OLD DOMINION DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-2723
Mailing Address - Country:US
Mailing Address - Phone:703-448-0923
Mailing Address - Fax:703-448-8639
Practice Address - Street 1:113 NORTH WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314
Practice Address - Country:UM
Practice Address - Phone:703-549-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000176152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT31174Medicare UPIN
VAJ412603Medicare ID - Type UnspecifiedMEDICARE NUMBER