Markus P. Heyder, D.D.S.
Individual provider Active NPI Dentist · Kitty Hawk, NC
NPI 1639130883 · NPPES record last updated Jan 10, 2014
Key facts
- NPI
- 1639130883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7775 (NC)
- Practice address
- 3704-B N. Croatan Highway
Kitty Hawk, NC 27949-9216 - Phone
- (252) 261-7700
- Fax
- (252) 261-1770
- NPI assigned
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7715 | NC | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7775 | NC | |
| Dentist | 122300000X | 7715 | NC | |
| Dentist | 122300000X | 7775 | NC | Yes |
Addresses
Primary practice location
3704-B N. Croatan Highway
Kitty Hawk, NC 27949-9216
Mailing address
3704-B. N. Croatan Highway
Kitty Hawk, NC 27949-9216
Phone (252) 261-7700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89902UB | Medicaid | NC | |
| 89902U8 | Medicaid | NC |
Other providers in Kitty Hawk, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.