Provider Demographics
NPI:1316130164
Name:CARRINGTON, VINCENT DAVIDSON (DENTIST DDS)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:DAVIDSON
Last Name:CARRINGTON
Suffix:
Gender:M
Credentials:DENTIST DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AMHERST CT UNIT 3
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3905
Mailing Address - Country:US
Mailing Address - Phone:718-963-9500
Mailing Address - Fax:718-963-9553
Practice Address - Street 1:110 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1304
Practice Address - Country:US
Practice Address - Phone:718-963-9500
Practice Address - Fax:718-963-9553
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101854200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01928647Medicaid