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GENESIS ORAL SURGERY
NPI 1679902407
Oral & Maxillofacial Surgery in Columbia, MD

Active since November 02, 2013
8860 COLUMBIA 100 PARKWAY, SUITE 308, COLUMBIA, MD 21045(410) 465-6800(410) 461-4727 Get Directions Write a Review

NPPES record last updated: September 29, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Genesis Oral Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS ORAL SURGERY (NPI 1679902407) is a healthcare organization registered as an oral & maxillofacial surgery in Columbia, Maryland and active in the NPI registry since November 2013. The organization lists Antoine Gerard Johnson, Oral Surgeon, as its authorized official.

NPPES Registry Identity

NPI1679902407
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameANTOINE G JOHNSON DDS LLC
Location Address8860 COLUMBIA 100 PARKWAY, SUITE 308Columbia, MD 21045
Mailing Address8860 Columbia 100 Parkway, Suite 308Columbia, MD 21045 · (410) 465-6800 · Fax (410) 461-4727
Phone(410) 465-6800
Fax(410) 461-4727
Organization SubpartNo
Authorized OfficialAntoine Gerard JohnsonOral Surgeon · (410) 465-6800
Enumeration DateNovember 2, 2013
Last NPPES UpdateSeptember 29, 2021
NPPES CertifiedSeptember 29, 2021
✔ NPI 1679902407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in MD · 14853
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
8860 COLUMBIA 100 PARKWAY, Columbia, MD 21045
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Other Names 1

Other NameGenesis Oral Surgery

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Genesis Oral Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Genesis Oral Surgery, which bills Medicare for the services this clinician delivers.

Clinician (1)

Antoine Johnson, DDS
Maxillofacial Surgery
NPI 1679730709
8860 COLUMBIA 100 PKWY STE 308
Columbia, MD 21045
(410) 465-6800
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antoine G Johnson Dds LLC's NPI number?

The NPI number for Antoine G Johnson Dds LLC is 1679902407. It was assigned to this organization in the NPPES registry on November 2, 2013. The provider is also known as Genesis Oral Surgery.

Where is Antoine G Johnson Dds LLC located?

Antoine G Johnson Dds LLC is located at 8860 Columbia 100 Parkway Suite 308, Columbia, MD 21045. The listed phone number is (410) 465-6800.

What is Antoine G Johnson Dds LLC's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Antoine G Johnson Dds LLC enrolled in Medicare?

Yes. Antoine G Johnson Dds LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Antoine G Johnson Dds LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Maxillofacial Surgery) reassigns their Medicare billing to Antoine G Johnson Dds LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Antoine G Johnson Dds LLC was last updated on September 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.