Provider Demographics
NPI:1942589106
Name:ARRINGTON, LATARSHA MONIQUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LATARSHA
Middle Name:MONIQUE
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4562 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-5335
Mailing Address - Country:US
Mailing Address - Phone:601-981-4322
Mailing Address - Fax:601-981-4323
Practice Address - Street 1:4562 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206
Practice Address - Country:US
Practice Address - Phone:601-981-4322
Practice Address - Fax:601-981-4323
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3612-111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice