Individual provider Active NPI

Mayank H. Dalal, M.D

  • Psychiatry Physician
  • Bennettsville, SC
National Provider Identifier
1457384935
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21346 Issued in SC
Practice address
1035 Cheraw St.
Bennettsville, SC 29512
Phone
(843) 544-4098
NPI assigned
Jul 8, 2006
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD21346 SC
Forensic Psychiatry Physician 2084F0202X 21346 SC
Psychiatry Physician 2084P0800X 21346 SC Primary
Child & Adolescent Psychiatry Physician 2084P0804X 21346 SC

Addresses

Primary practice location

1035 Cheraw St.
Bennettsville, SC 29512

Mailing address

7901 Farrow Rd
Columbia, SC 29203-3220
Phone (843) 544-4098

Other identifiers 1

IdentifierTypeStateIssuer
213469MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061024000324 SC Practitioner - Psychiatry 7517964117 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD21346SCMDSpecialist
21346SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Feb 10, 2015 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 21, 2023 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Feb 10, 2015 Accepting new patients

Locations

1035 Cheraw St
Bennettsville, SC 29512
Phone (843) 454-0442

524 Doctors Ct
Chester, SC 29706
Phone (803) 325-7744

1800 Colonial Dr
Columbia, SC 29203
Phone (803) 898-0123

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

7901 Farrow Rd
Columbia, SC 29203
Phone (803) 734-7846

1906 Highway 521 Byp S
Lancaster, SC 29720
Phone (803) 285-1456

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1457384935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 FARROW RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033220",
            "telephone_number": "843-544-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 CHERAW ST.",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "29512",
            "telephone_number": "843-544-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAL",
        "first_name": "MAYANK",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "MD21346",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "SC",
            "license": "21346",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "21346",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "21346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213469",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennettsville, SC

Sources for this page

Verify at the official NPI Registry.