Active NPI
Donald Alan Lonergan, DMD
- Prosthodontics
- Beaufort, SD
National Provider Identifier
1376523365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 019021154
- Practice address
- 1 Pinckney Blvd
Beaufort, SD 29935 - Phone
- (843) 228-3500
- NPI assigned
- Jan 18, 2006
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 019021154 | IL | Primary |
Addresses
Primary practice location
1 Pinckney Blvd
Beaufort, SD 29935
Mailing address
6 Flamingo CV
Beaufort, SC 29907-1824
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019021154 | IL | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1376523365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 FLAMINGO CV",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299071824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PINCKNEY BLVD",
"city": "BEAUFORT",
"state": "SD",
"postal_code": "29935",
"telephone_number": "843-228-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONERGAN",
"first_name": "DONALD",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IL",
"license": "019021154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.