Healthcare Provider Details

I. General information

NPI: 1649100942
Provider Name (Legal Business Name): DR. DEOR ZOHAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 N KINGS HWY
MYRTLE BEACH SC
29572-3062
US

IV. Provider business mailing address

435 OAKMONT DR
MYRTLE BEACH SC
29579-7286
US

V. Phone/Fax

Practice location:
  • Phone: 843-597-8580
  • Fax:
Mailing address:
  • Phone: 843-597-8580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11425
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: