Healthcare Provider Details

I. General information

NPI: 1295196962
Provider Name (Legal Business Name): BRITTNEY CLONINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PARKWAY CTR STE G1
PITTSBURGH PA
15220
US

IV. Provider business mailing address

2 PARKWAY CTR STE G1
PITTSBURGH PA
15220-3510
US

V. Phone/Fax

Practice location:
  • Phone: 412-937-1900
  • Fax:
Mailing address:
  • Phone: 412-937-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDA031802
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS040677
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: