Provider Demographics
NPI:1659680254
Name:DOERING, NINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:DOERING
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 1:422 HIGHLAND FOREST DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2711
Mailing Address - Country:US
Mailing Address - Phone:310-871-7308
Mailing Address - Fax:
Practice Address - Street 1:JOEL DENTAL CLINIC BLDG M4861 LOGISTICS AVE
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-5460
Practice Address - Country:US
Practice Address - Phone:310-871-7308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1014181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice