Individual
DR. MATTHEW JEFFREY JOHNSON
Active
Individual
DR. MATTHEW JEFFREY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9900556
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1218U
BCBS
NC
01
—
536660
UNITED CONCORDIA DENTAL
NC
01
—
5738691002
CIGNA
NC
01
—
7082247
AETNA
NC
01
—
8742082
UNITED HEALTHCARE
NC
05
—
891218U
—
NC
01
—
89902HV
MEDICAID DENTAL
NC
Enumeration date
09/28/2006
Last updated
02/08/2008
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