Provider Demographics
NPI:1568776664
Name:HERRING, MARVA JEAN (DDS)
Entity Type:Individual
Prefix:
First Name:MARVA
Middle Name:JEAN
Last Name:HERRING
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 1:1818 NEW YORK AVE NE
Mailing Address - Street 2:SUITE #116
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1848
Mailing Address - Country:US
Mailing Address - Phone:202-450-2344
Mailing Address - Fax:202-450-2400
Practice Address - Street 1:1818 NEW YORK AVE NE
Practice Address - Street 2:SUITE # 116
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1848
Practice Address - Country:US
Practice Address - Phone:202-450-2344
Practice Address - Fax:202-450-2400
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN5001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCDEN5001OtherDEPT OF HEALTH BOARD OF DENTISTRY