Provider Demographics
NPI:1518915461
Name:JOHNSON-HIGGINS, GINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:JOHNSON-HIGGINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1738
Mailing Address - Country:US
Mailing Address - Phone:859-269-2667
Mailing Address - Fax:859-269-7761
Practice Address - Street 1:614 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1738
Practice Address - Country:US
Practice Address - Phone:859-269-2667
Practice Address - Fax:859-269-7761
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY75261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice