Arezo Hesaraki, DDS is a medicare enrolled "Dentist - General Practice" provider in Oak Grove, Missouri. Her current practice location is
2016 S Broadway, Oak Grove, Missouri. You can reach out to her office (for appointments etc.) via phone at
(816) 690-4141.
Arezo Hesaraki is licensed to practice in Missouri (license number 2014031462) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174928857.
Healthcare Provider's Profile
| Full Name | Arezo Hesaraki |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 2016 S Broadway, Oak Grove, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1174928857
- Provider Enumeration Date: 10/23/2014
- Last Update Date: 10/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 3577852417
- Enrollment ID: I20160517001810
Medical Identifiers
Medical identifiers for Arezo Hesaraki such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174928857 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 2014031462 (Missouri) | Primary |
| 1223G0001X | Dentist - General Practice | 61113 (Kansas) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Arezo Hesaraki allows following entities to bill medicare on her behalf.
| Entity Name | Swope Health Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861587511
PECOS PAC ID: 5294644530
Enrollment ID: O20110921000686 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Arezo Hesaraki is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Arezo Hesaraki, DDS
1050 W 10th St, Ste 480,
Rolla, MO 65401-2905
Ph: (816) 690-4141 | Arezo Hesaraki, DDS
2016 S Broadway,
Oak Grove, MO 64075-8439
Ph: (816) 690-4141 |
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