Provider Demographics
NPI:1619602273
Name:JOHNSON, ALAINA GAUTHIER (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAINA
Middle Name:GAUTHIER
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:RAE
Other - Last Name:GAUTHIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:106 QUEEN PALM CIR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592
Mailing Address - Country:US
Mailing Address - Phone:337-254-9008
Mailing Address - Fax:
Practice Address - Street 1:204 CRESCENT RANCH BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7530
Practice Address - Country:US
Practice Address - Phone:337-408-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK76171223G0001X
LA76051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice