DR. CREED S HAYMOND DDS
NPI 1689781189
Dentist - Oral and Maxillofacial Surgery in Sandy, UT
NPI Status: Active since August 23, 2006
Contact Information
1434 E 9400 S
STE 102
SANDY, UT
ZIP 84093
Phone: (801) 576-0077
Fax: (801) 495-1837
- Individual
- Male
- Dentist
- Oral and Maxillofacial Surgery
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About CREED HAYMOND
This page provides the complete NPI Profile along with additional information for Creed Haymond, a provider established in Sandy, Utah with a medical specialization in Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1689781189 assigned on August 2006. The practitioner's primary taxonomy code is 1223S0112X with license number 1453789924 (UT). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1689781189
- Provider Name
- DR. CREED S HAYMOND DDS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1434 E 9400 S STE 102 SANDY, UT 84093
- Location Phone
- (801) 576-0077
- Location Fax
- (801) 495-1837
- Mailing Address
- 1434 E 9400 S STE 102 SANDY, UT 84093
- Mailing Phone
- (801) 576-0077
- Mailing Fax
- (801) 495-1837
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-23-2006
- Last Update Date
- 11-16-2010
- Code Navigator
A dentist like Creed Haymond is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Creed Haymond opted out of Medicare effective on 06-07-2016 until 06-07-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 1453789924
- License State
- UT
- Taxonomy Description
- An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223S0112X | Dental Providers | Dentist | 1453788903 (UT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 9200 (+ Incentives) - EPO
- Anthem Bronze Pathway HMO 7450 for HSA - HMO
- Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- BEST Life Superior Dental Plan - PPO
- BEST Essential Basic Dental Plan - PPO
- BEST Life Essentail Basic Dental Plan - PPO
- BEST Life Essentail Value Dental Plan - PPO
- BEST Life Essental Value Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Vakue Dental Plan - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Essential Value Dental - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental plan - PPO
- BEST Life Superior Dental - PPO
- BEST Life Superior Dental Plan - PPO
- BEST Life Superior Dental Plan - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BridgeSpan Standard Bronze Plan - HMO
- BridgeSpan Standard Gold Plan - HMO
- BridgeSpan Standard Silver Plan - HMO
- Delta Dental PPO Basic Plan for Families - PPO
- Delta Dental PPO Preferred Plan for Families - PPO
- EMI Health Advantage Co-Pay - PPO
- EMI Health Advantage PPO - PPO
- EMI Health Choice PPO - PPO
- EMI Health Choice PPO (High) - PPO
- EMI Health EHB Pediatric Plan � Advantage Network - EPO
- EMI Health EHB Pediatric Plan � Premier Network - EPO
- BlueDental Copayment Q - PPO
- BlueDental Copayment QF - PPO
- Guardian Choice for Families and Individuals - PPO
- Guardian Essentials for Families and Individuals - PPO
- Guardian Preventive Plus for Families and Individuals - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Paramount Dental Essential Plus Plan - EPO
- Paramount Dental Preventive Family Plan - EPO
- Paramount Dental Total Care Plan - EPO
- HRI Essential Plus Plan - HMO
- HRI Essential Plus Plan - PPO
- HRI Preventive Family Plan - HMO
- HRI Preventive Family Plan - PPO
- HRI Total Care Plan - HMO
- HRI Total Care Plan - PPO
- Bronze Essential 8500 Deductible With 4 Copay No Deductible Office Visits - EPO
- Bronze HSA 7000 - EPO
- Gold 2300 - EPO
- Regence Standard Bronze 7500 - EPO
- Regence Standard Gold 1500 - EPO
- Regence Standard Silver 5000 - EPO
- SaveWell Standard Bronze 7500 - EPO
- SaveWell Standard Gold 1500 - EPO
- SaveWell Standard Silver 5000 - EPO
- Silver 5000 - EPO
- Silver 6200 - EPO
- Alabama Preferred Plan - PPO
- Alabama Preferred Plan (Pediatric Only) - PPO
- Alabama Preferred Plus Plan - PPO
- Alabama Preferred Plus Plan (Pediatric Only) - PPO
- Alabama Wellness Essentials Plan - PPO
- Florida Preferred Plan - PPO
- Florida Preferred Plan (Pediatric Only) - PPO
- Florida Preferred Plus Plan - PPO
- Florida Preferred Plus Plan (Pediatric Only) - PPO
- Florida Wellness Essentials Plan - PPO
- High PPO Dental Plan - PPO
- High PPO Dental Plan (Pediatric Only) - PPO
- Kansas Preferred Plan - PPO
- Kansas Preferred Plan (Pediatric Only) - PPO
- Kansas Wellness Essentials Plan - PPO
- Low PPO Dental Plan - PPO
- Low PPO Dental Plan (Pediatric Only) - PPO
- Mississippi Preferred Plan - PPO
- Mississippi Preferred Plan (Pediatric Only) - PPO
- Mississippi Wellness Essentials Plan - PPO
- Med Benchmark Expanded Bronze Select Copay Plan - HMO
- Med Benchmark Expanded Bronze Standardized Plan - HMO
- Med Benchmark Gold Standardized Plan - HMO
- Med Benchmark Platinum - HMO
- Med Benchmark Platinum Standardized Plan - HMO
- Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
- Med Benchmark Silver Standardized Plan - HMO
- Med Gold 1500 Medical Deductible - HMO
- Value Expanded Bronze 6900 Medical Deductible - HMO
- Value Gold 1500 Medical Deductible - HMO
- Value Silver 3000 Medical Deductible - HMO
- Smile Now Arizona - No Waiting Period PPO - PPO
- Smile Now Illinois - No Waiting Period PPO - PPO
- Smile Now Michigan - No Waiting Period PPO - PPO
- Smile Now Ohio - No Waiting Period PPO - PPO
- Smile Now Tennessee - No Waiting Period PPO - PPO
- Smile Now Texas- No Waiting Period Plan - PPO
- Smile Now Utah - No Waiting Period PPO - PPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay - EPO
- Healthy Premier Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| I45378 | MEDICARE UPIN (02) | ||
| 000010305 | MEDICARE ID-TYPE UNSPECIFIED (04) |
Medicare Participation & PECOS Enrollment Status
Creed Haymond is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 06-07-2016
Opt-Out End Date: 06-07-2026
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 84093 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.41
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.03
- Average New Patient Copayment $21.1
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.5
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.01
- Minimum Established Patient Price $17.23
- Maximum Established Patient Price $135.2
- Average Established Patient Copayment $17
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.8
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 8 | 9 | 7 | 8 | 1 | 1 | 8 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 16 | 9 | 14 | 8 | 2 | 1 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 6 + 9 + 1 + 4 + 8 + 2 + 1 + 1 + 6 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1689781189 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1700894185 | DR. RANDY L WEBB DDS Individual | Dentist (General Practice) | 1434 E 9400 S # 206 SANDY, UT 84093 (801) 571-0063 |
| 1184723165 | DR. DAVID NILS LOFGREN MD Individual | Pediatrics | 1434 E 9400 S SUITE 100 SANDY, UT 84093 (801) 572-9369 |
| 1891872263 | RUSSELL G. LEWIS DDS PC Organization | Dentist (General Practice) | 1434 E 9400 S #201 SANDY, UT 84093 (801) 572-0942 |
| 1912073164 | STEVEN SHELTON DPM Individual | Podiatrist | 1434 E 9400 S STE 203 SANDY, UT 84093 (801) 571-7911 |
| 1245385319 | BARBARA EVE RIZZARDI MD Individual | Internal Medicine | 1434 E 9400 S #208 SANDY, UT 84093 (801) 576-8333 |
| 1033326129 | DR. DAVID H WEBB D.D.S. Individual | Dentist (General Practice) | 1434 E 9400 S SUITE #206 SANDY, UT 84093 (801) 572-0226 |
| 1740476407 | DR. MATTHEW D. WEBB DDS Individual | Dentist (General Practice) | 1434 E 9400 S SUITE 206 SANDY, UT 84093 (801) 571-0063 |
| 1225279995 | DR. RANDALL KAY JOHNSON DDS Individual | Dentist (General Practice) | 1434 E 9400 S SUITE 200 SANDY, UT 84093 (801) 572-4404 |
| 1508007279 | DR. BART TAFT WATTS DDS Individual | Dentist (General Practice) | 1434 E 9400 S SUITE 200 SANDY, UT 84093 (801) 572-4404 |
| 1003104480 | DR. RAND BROWN D.D.S. Individual | Dentist (Orthodontics and Dentofacial Orthopedics) | 1434 E 9400 S SUITE 204 SANDY, UT 84093 (801) 571-1995 |
| 1275093247 | KEVIN P HAGOOD DDS Individual | Dentist | 1434 E 9400 S SANDY, UT 84093 (385) 722-4686 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689781189, enumerated in the NPI registry as an "individual" on August 23, 2006
The provider is located at 1434 E 9400 S Ste 102 Sandy, Ut 84093 and the phone number is (801) 576-0077
The provider's speciality is Dentist with taxonomy code 1223S0112X with a focus in Oral and Maxillofacial Surgery
The provider might be accepting Accepts: Aetna CVS Health, Anthem Blue Cross and Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $84.41 with an average copayment of $21.1 for new patient appointments. Established patients should expect a typical charge of $68.01 and an average copayment of 17. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on June 07, 2016 to opt-out of the Medicare program. The provider is excluded from the Medicare program until June 07, 2026.
This NPI record was last updated on August 23, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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