Yawer Bashir

Individual provider Active NPI General Practice Dentistry · Garner, NC

NPI 1861004632 · NPPES record last updated Aug 21, 2020

Key facts

NPI
1861004632
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12020 (NC)
Practice address
12450 Cleveland Rd
Garner, NC 27529-8353
Phone
(607) 386-8713
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
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
I20200915000720 NC Order and Referring Only - Dentist
Practitioner - Dentist
2961820592

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12020 NC Yes

Addresses

Primary practice location

12450 Cleveland Rd
Garner, NC 27529-8353

Mailing address

820 Sumner Dr Apt 5
Fayetteville, NC 28303-5542

Other providers in Garner, NC

All providers in Garner, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.