Provider Demographics
NPI:1437274693
Name:KRONINGER, BARBARA ANN (DDS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:KRONINGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:160 SAILORS DRIVE
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30540-0008
Mailing Address - Country:US
Mailing Address - Phone:706-276-2828
Mailing Address - Fax:706-276-2826
Practice Address - Street 1:160 SAILORS DR
Practice Address - Street 2:
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-3743
Practice Address - Country:US
Practice Address - Phone:706-276-2828
Practice Address - Fax:706-276-2826
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011385122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000682976DMedicaid
GA000682976CMedicaid
GABT0753524OtherDEA REGISTRATION