Dr Mark Henry Habermeyer, DDS is a medicare enrolled "Dentist" provider in Riverdale, Utah. His current practice location is
4115 Riverdale Rd Ste B, Riverdale, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 940-5555.
Dr Mark Henry Habermeyer is licensed to practice in Utah (license number 9231171-9921) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720095631.
Healthcare Provider's Profile
Full Name | Dr Mark Henry Habermeyer |
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Gender | Male |
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Speciality | Dentist |
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Location | 4115 Riverdale Rd Ste B, Riverdale, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1720095631
- Provider Enumeration Date: 08/02/2006
- Last Update Date: 12/08/2015
Medicare PECOS Information:
- PECOS PAC ID: 2163736919
- Enrollment ID: I20150806011882
Medical Identifiers
Medical identifiers for Dr Mark Henry Habermeyer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720095631 | NPI | - | NPPES |
9231171-9921 | Other | UT | STATE OF UTAH DEPARTMENT OF COMMERCE |
508064 | Other | CA | DENTICAL |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 9231171-9921 (Utah) | Primary |
1223G0001X | Dentist - General Practice | 26994 (California) | Secondary |
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. Dr Mark Henry Habermeyer 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 |
Dr Mark Henry Habermeyer, DDS 4115 Riverdale Rd Ste B, Riverdale, UT 84405-3509 Ph: (801) 940-5555 | Dr Mark Henry Habermeyer, DDS 4115 Riverdale Rd Ste B, Riverdale, UT 84405-3509 Ph: (801) 940-5555 |
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