Individual provider Active NPI

Joseph Michael Cronin, DDS

  • Dentist
  • Hattiesburg, MS
National Provider Identifier
1255994828
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4115-20 Issued in MS
Practice address
112 Lamar Blvd
Hattiesburg, MS 39402-8147
Phone
(601) 450-5550
NPI assigned
Apr 18, 2019
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4115-20 MS Primary

Addresses

Primary practice location

112 Lamar Blvd
Hattiesburg, MS 39402-8147

Mailing address

3030 Montfort Loop
Richmond, VA 23294-5235
Phone (801) 857-8311

Other practice location 1

440 Broad St
Columbia, MS 39429-3006
Phone (601) 736-1761

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4115-20MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Dental Mobile LLC Dentist PastSince Mar 12, 2024 Accepting new patients
Cronin Dentistry of Columbia LLC PastSince Oct 31, 2021 Accepting new patients
Cronin Family Dentistry PA PastSince Jan 14, 2024 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1255994828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 MONTFORT LOOP",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232945235",
            "telephone_number": "801-857-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LAMAR BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028147",
            "telephone_number": "601-450-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MS",
            "postal_code": "394293006",
            "country_code": "US",
            "telephone_number": "601-736-1761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4115-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.