Sanjay Bhatt, DDS, MD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Simpsonville, SC
NPI 1124403407 · NPPES record last updated Nov 7, 2022
Key facts
- NPI
- 1124403407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 10265 (SC)
- Practice address
- 883 NE Main St
Simpsonville, SC 29681-2051 - Phone
- (864) 756-1060
- NPI assigned
- Jul 28, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 11, 2022 through Mar 11, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ETN338 | TX | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ccofs Oral Surgery 2 LLC | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
| DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho | Past | Accepting new patients |
Interoperability endpoints
- sbhatt417077@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | ETN338 | TX | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 10265 | SC | Yes |
Addresses
Primary practice location
883 NE Main St
Simpsonville, SC 29681-2051
Mailing address
883 NE Main St
Simpsonville, SC 29681-2051
Phone (864) 756-1060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ETN338 | Other | TX | TEXAS STATE BOARD OF DENTAL EXAMINERS |
Other providers in Simpsonville, SC
- Bends Dialysis LLC
- Bennefield & Associates, LLC
- Michelle Clayton Benton
- Mark Elliot Berke
- Benjamin Henry Bertino
- Thomas David Bidwell
- Nivedita S Bijoor
- Laurel Delaney Black
- Sonja Rena Black
- Daniel Blackmon
All providers in Simpsonville, SC · Oral and Maxillofacial Surgery (Dentist) in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.