Active NPI
Mark Joseph Lonergan, D.M.D.
- Oral and Maxillofacial Surgery (Dentist)
- Holland, MI
National Provider Identifier
1952384521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 2901016242
- Practice address
- 601 Michigan Ave
Suite 200
Holland, MI 49423-4951 - Phone
- (616) 392-2329
- Fax
- (616) 392-9610
- NPI assigned
- Nov 28, 2005
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 2901016242 | PA | Primary |
Addresses
Primary practice location
601 Michigan Ave
Suite 200
Holland, MI 49423-4951
Mailing address
601 Michigan Ave
Suite 200
Holland, MI 49423-4951
Phone (616) 392-2329
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2987145 | Medicaid | MI | |
| 9757060360 | Other | MI | BCBS MEDICAL |
| 2980879 | Medicaid | MI | |
| D162420 | Other | MI | BCBS DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 2, 2024 through Oct 2, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901016242 | PA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1952384521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 MICHIGAN AVE",
"address_2": "SUITE 200",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494234951",
"telephone_number": "616-392-2329",
"fax_number": "616-392-9610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 MICHIGAN AVE",
"address_2": "SUITE 200",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494234951",
"telephone_number": "616-392-2329",
"fax_number": "616-392-9610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONERGAN",
"first_name": "MARK",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "2901016242",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2987145",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MEDICAL",
"identifier": "9757060360",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2980879",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS DENTAL",
"identifier": "D162420",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.