Individual provider Active NPI

Erin Rebecca Heavner

  • General Practice Dentistry
  • Lincolnton, NC
National Provider Identifier
1316516891
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12278 Issued in NC
Practice address
904 Dontia Dr
Lincolnton, NC 28092-3643
Phone
(704) 735-0765
Fax
(704) 735-4506
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12278 NC Primary

Addresses

Primary practice location

904 Dontia Dr
Lincolnton, NC 28092-3643

Mailing address

300 Kennedy Dr
Lincolnton, NC 28092-3216
Phone (704) 813-1114

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
12278NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John L. Cloninger, III, D.D.S., PLLC General Practice CurrentSince Jun 27, 2021 Accepting new patients

Locations

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

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1316516891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KENNEDY DR",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923216",
            "telephone_number": "704-813-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 DONTIA DR",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923643",
            "telephone_number": "704-735-0765",
            "fax_number": "704-735-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVNER",
        "first_name": "ERIN",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12278",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 21, 2021; 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.