Provider Demographics
NPI:1144664541
Name:HERINGER, EVERETT E (DENTIST)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:E
Last Name:HERINGER
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 LARSON RD
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-8926
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
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice