Active NPI
Jonathan Dale Liner, D.D.S.
- General Practice Dentistry
- Wilkesboro, NC
National Provider Identifier
1750464046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6839
- Practice address
- 1690 River St
Wilkesboro, NC 28697-7630 - Phone
- (336) 838-9400
- Fax
- (336) 838-1872
- NPI assigned
- Oct 23, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6839 | NC | Primary |
Addresses
Primary practice location
1690 River St
Wilkesboro, NC 28697-7630
Mailing address
1690 River St
Wilkesboro, NC 28697-7630
Phone (336) 838-9400
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 841955 | Other | NC | UNITED CONCORDIA |
| 790154Y | Medicaid | NC | |
| 0154Y | Other | NC | BCBS |
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 |
|---|---|---|---|
| 6839 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonathan Liner DDS | Current | Accepting new patients | |
| Liner, Ward & Shobe DDS, PA | Past | Accepting new patients |
Locations
1690 River St
Wilkesboro, NC 28697
Phone (336) 838-9400
Organizations & group practices 2
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": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750464046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1690 RIVER ST",
"city": "WILKESBORO",
"state": "NC",
"postal_code": "286977630",
"telephone_number": "336-838-9400",
"fax_number": "336-838-1872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1690 RIVER ST",
"city": "WILKESBORO",
"state": "NC",
"postal_code": "286977630",
"telephone_number": "336-838-9400",
"fax_number": "336-838-1872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINER",
"first_name": "JONATHAN",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "6839",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "841955",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "790154Y",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0154Y",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilkesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.