# ANTOINE G JOHNSON DDS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesis Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679902407
- **Authorized official:** DR. ANTOINE GERARD JOHNSON DDS (ORAL SURGEON)
- **Authorized official phone:** (410) 465-6800

## Contact information

- **Practice address:** 8860 COLUMBIA 100 PARKWAY, SUITE 308, COLUMBIA, MD 21045
- **Practice address phone:** (410) 465-6800
- **Practice address fax:** (410) 461-4727
- **Mailing address:** 8860 COLUMBIA 100 PARKWAY, SUITE 308, COLUMBIA, MD 21045
- **Mailing address phone:** (410) 465-6800
- **Mailing address fax:** (410) 461-4727

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 14853 | MD | Yes |

## Other

- **Enumeration date:** 11/02/2013
- **Last updated:** 09/29/2021