Individual provider Active NPI

Harvey Eugene Butler III, D.M.D.

  • General Practice Dentistry
  • Myrtle Beach, SC
National Provider Identifier
1861645715
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2977 Issued in SC
Practice address
304 79TH Ave N
Myrtle Beach, SC 29572-4304
Phone
(843) 449-4812
Fax
(843) 449-3632
NPI assigned
Oct 23, 2008
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2977 SC Primary

Addresses

Primary practice location

304 79TH Ave N
Myrtle Beach, SC 29572-4304

Mailing address

304 79TH Ave N
Myrtle Beach, SC 29572-4304
Phone (843) 449-4812

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150413000282 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911225552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2977SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zachary W McMillan DMD LLC General Practice PastSince Dec 17, 2023 Accepting new patients
Dunes Dental Association General Practice Past Accepting new patients

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, 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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1861645715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724304",
            "telephone_number": "843-449-4812",
            "fax_number": "843-449-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724304",
            "telephone_number": "843-449-4812",
            "fax_number": "843-449-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "HARVEY",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-23",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.