Provider Demographics
NPI:1295357853
Name:HERRING, BRANDY (DMD)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:HERRING
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 1:300 ASHVILLE AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8694
Mailing Address - Country:US
Mailing Address - Phone:919-852-1811
Mailing Address - Fax:
Practice Address - Street 1:300 ASHVILLE AVE STE 270
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8694
Practice Address - Country:US
Practice Address - Phone:919-852-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-17
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11874122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Yes122300000XDental ProvidersDentist