Provider Demographics
NPI:1619652146
Name:JOHNSON, HANNAH C (DMD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:C
Last Name:JOHNSON
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 1:90 E CATAWBA ST APT 412
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-4199
Mailing Address - Country:US
Mailing Address - Phone:832-628-5339
Mailing Address - Fax:
Practice Address - Street 1:203 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3831
Practice Address - Country:US
Practice Address - Phone:704-825-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist