Megan Arellano Hanvivatpong, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN25364 Issued in FL

Practice address

1321 NW Saint Lucie West Blvd
Port St Lucie, FL 34986-2139

Phone

(772) 343-0179

NPI assigned

Feb 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1891295523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862139",
            "telephone_number": "772-343-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862139",
            "telephone_number": "772-343-0179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway # 2C319",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-8310",
            "fax_number": "718-630-3244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Sleepy Hollow",
            "state": "NY",
            "postal_code": "10591",
            "country_code": "US",
            "telephone_number": "914-366-1138",
            "fax_number": "914-366-1017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANVIVATPONG",
        "first_name": "MEGAN",
        "middle_name": "ARELLANO",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hands of St. Lucie County
• Hands on Performance LLC
• Beverly Sue Hanna
• Kelly Hannah, OTR/L
• Kristen Hanrahan, DO
• Liam Harb, DDS
• Hardcore Support Services, Inc.
• Shakeya Lashae Hargrove, CRDH
• Isabellah Hariharan
• Harmony Care Home

• General Practice Dentistry in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.