Provider Demographics
NPI:1477130789
Name:HARRINGTON, AMANDA RENE (DDS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENE
Last Name:HARRINGTON
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 1:3705 FLINTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-1235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MEHARRY SCHOOL OF DENTISTRY
Practice Address - Street 2:1801 MEHARRY BLVD
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000119491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN11949OtherLICENSE NUMBER