Active NPI
Abdel Hassan Darensburg, D.D.S.
- Dentist
- North Myrtle Beach, SC
National Provider Identifier
1396913208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 053774
- Practice address
- 1240 Highway 17 S
North Myrtle Beach, SC 29582-3707 - Phone
- (843) 663-1013
- Fax
- (843) 663-1017
- NPI assigned
- Feb 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 053774 | NY | Primary |
Addresses
Primary practice location
1240 Highway 17 S
North Myrtle Beach, SC 29582-3707
Mailing address
PO Box 547
Little River, SC 29566-0547
Phone (843) 663-1013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241018001353 | VA | Order and Referring Only - Dentist | 9032641774 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053774 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little River Medical Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Myrtle Beach, SC
- NPI 1144472119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296172800000",
"number": "1396913208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 547",
"city": "LITTLE RIVER",
"state": "SC",
"postal_code": "295660547",
"telephone_number": "843-663-1013",
"fax_number": "843-663-1017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 HIGHWAY 17 S",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295823707",
"telephone_number": "843-663-1013",
"fax_number": "843-663-1017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARENSBURG",
"first_name": "ABDEL",
"middle_name": "HASSAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-13",
"last_updated": "2011-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "053774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Myrtle Beach, SC
- CVS Caremark
- Shannon Marie Cyr
- D. Calvin Riley Jr. DMD PA (Crescent Beach Dental)
- Tasha Damon
- Ashley Nicole Daniels, RBT
- William T. Davis, DDS
- Robert Allan Day, CPO
- Stephanie Hurst Deal, LPTA
- Dental Professionals of SC, PC (North Myrtle Beach Dentistry)
- Dental Professionals of South Carolina (Gentle Dental Care of North Myrtle Beach)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.