Provider Demographics
NPI:1891872545
Name:HERINGER DENTISTRY LLC
Entity Type:Organization
Organization Name:HERINGER DENTISTRY LLC
Other - Org Name:EVERETT E. HERINGER, D.D.S., P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:701-255-4850
Mailing Address - Street 1:1839 E CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-5616
Mailing Address - Country:US
Mailing Address - Phone:701-255-4850
Mailing Address - Fax:701-255-4852
Practice Address - Street 1:1839 E CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-5616
Practice Address - Country:US
Practice Address - Phone:701-255-4850
Practice Address - Fax:701-255-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty