Provider Demographics
NPI:1295196962
Name:CLONINGER, BRITTNEY
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:CLONINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PARKWAY CTR STE G1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3510
Mailing Address - Country:US
Mailing Address - Phone:412-937-1900
Mailing Address - Fax:
Practice Address - Street 1:2 PARKWAY CTR STE G1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220
Practice Address - Country:US
Practice Address - Phone:412-937-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADA0318021223D0004X
PADS040677122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No122300000XDental ProvidersDentist