Provider Demographics
NPI:1992262588
Name:HERRINGTON, MORGAN LEIGH (DMD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:LEIGH
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MORGAN
Other - Middle Name:LEIGH
Other - Last Name:NIEWERTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1544 OLD TAMAH RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063
Mailing Address - Country:US
Mailing Address - Phone:803-732-7223
Mailing Address - Fax:
Practice Address - Street 1:1544 OLD TAMAH RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063
Practice Address - Country:US
Practice Address - Phone:803-732-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93751223X0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty