MEDICARE: DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1760103535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.

Provider Business Mailing Address
First Line	:	940 WOOD DUCK DR STE 104
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-9412
Country	:	US
Telephone Number	:	843-213-1194
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 WOOD DUCK DR STE 104
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-9412
Country	:	US
Telephone Number	:	843-213-1194
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	BELINDA HUERTA
Credential	:
Telephone Number	:	217-540-2100

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

Similar Medicare Providers

1821511452 — NICOLE MILLER PHARMD
Practice Location Address:

955 WOOD DUCK DR
MYRTLE BEACH, SC
29577-9412

Practice Phone: 843-691-6041
Practice Fax:

1285367599 — PUBLIX SUPER MARKETS, INC.
Practice Location Address:

955 WOOD DUCK DR
MYRTLE BEACH, SC
29577-9412

Practice Phone: 843-691-6041
Practice Fax: 843-492-6276

1194581082 — LYNN COOK SR
Practice Location Address:

9412 MYRTLE AVE APT 179
KANSAS CITY, MO
64132-3852

Practice Phone: 816-986-7556
Practice Fax:

1205976875 — DR. BARRY M SIMON O.D.
Practice Location Address:

3788 W HILLSBORO BLVD
DEERFIELD BEACH, FL
33442-9412

Practice Phone: 954-425-8040
Practice Fax: 954-421-7449

1184946519 — BARRY M. SIMON, O.D., P.A.
Practice Location Address:

3788 W HILLSBORO BLVD
DEERFIELD BEACH, FL
33442-9412

Practice Phone: 954-360-0033
Practice Fax:

1871876417 — MR. WAYNE SWERDLOW
Practice Location Address:

3768 W HILLSBORO BLVD
DEERFIELD BEACH, FL
33442-9412

Practice Phone: 954-360-7606
Practice Fax: 954-360-9832

Directions to “DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.