Organization Active NPI

John L. Cloninger, III, D.D.S., PLLC

  • General Practice Dentistry
  • Lincolnton, NC
National Provider Identifier
1285808469
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JOHN L. CLONINGER, III, D.D.S., PLLC
Practice address
904 Donita Dr
Lincolnton, NC 28092-3643
Phone
(704) 735-0765
Fax
(704) 735-4506
NPI assigned
Apr 17, 2008
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Dr. John L Cloninger III, DDS, PLLC
Title
President
Phone
(704) 735-0765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

904 Donita Dr
Lincolnton, NC 28092-3643

Mailing address

904 Donita Dr
Lincolnton, NC 28092-3643
Phone (704) 735-0765

Other identifiers 4

IdentifierTypeStateIssuer
148930391OtherDELTA DENTAL
91684OtherBCBS
873537OtherUNITED CONCORDIA
8991684MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200824001294 NC Part B Supplier - Clinic/Group Practice 0648697532 Receives reassigned benefits from 1 practitioner
Practice locations: Lincolnton, NC

National Provider Directory

National Provider Directory

Locations

904 Dontia Dr
Lincolnton, NC 28092
Phone (704) 735-0765

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1285808469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 DONITA DR",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923643",
            "telephone_number": "704-735-0765",
            "fax_number": "704-735-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 DONITA DR",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923643",
            "telephone_number": "704-735-0765",
            "fax_number": "704-735-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN L. CLONINGER, III, D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "CLONINGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-735-0765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS, PLLC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "148930391",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "91684",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "873537",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8991684",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.