Haneen Anbarserri, DMD

Individual provider Active NPI General Practice Dentistry · Myrtle Beach, SC

NPI 1417520362 · NPPES record last updated Jul 19, 2021

Key facts

NPI
1417520362
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
10008 (SC)
Practice address
1430 S Commons Dr
Myrtle Beach, SC 29588-8087
Phone
(843) 712-7308
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241008003239 SC Order and Referring Only - Dentist
Practitioner - Dentist
9133650617

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professionals of South Carolina, P.C. General Practice Current
since Jul 25, 2021
Accepting new patients
Bishopville Dental LLC Current Accepting new patients

Locations

1430 S Commons Dr
Myrtle Beach, SC 29588
Phone (843) 712-7308

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10008 SC Yes

Addresses

Primary practice location

1430 S Commons Dr
Myrtle Beach, SC 29588-8087

Mailing address

257 Columbia Ave
Cliffside Park, NJ 07010-2499
Phone (201) 994-6117

Other providers in Myrtle Beach, SC

All providers in Myrtle Beach, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.