Caitlyn Johnson, DMD

Individual provider Active NPI Dentist · Fountain Inn, SC

NPI 1801580907 · NPPES record last updated Mar 17, 2026

Key facts

NPI
1801580907
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
10500 (SC)
Practice address
1125 N Main St
Fountain Inn, SC 29644-1322
Phone
(904) 563-2491
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10500SCMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10500 SC Yes

Addresses

Primary practice location

1125 N Main St
Fountain Inn, SC 29644-1322

Mailing address

4 Aldershot Way
Simpsonville, SC 29681-4375
Phone (904) 563-2491

Other providers in Fountain Inn, SC

All providers in Fountain Inn, SC · Dentist in South Carolina

Sources for this page

Verify at the official NPI Registry.