Dr Terri Ann Eubanks, DDS is a medicare enrolled "Dentist - General Practice" provider in Dermott, Arkansas. Her current practice location is
300 S School St, Dermott, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(870) 538-9720.
Dr Terri Ann Eubanks is licensed to practice in Arkansas (license number 2854) 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 1306960737.
Healthcare Provider's Profile
| Full Name | Dr Terri Ann Eubanks |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 300 S School St, Dermott, Arkansas |
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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: 1306960737
- Provider Enumeration Date: 03/19/2007
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 6507161197
- Enrollment ID: I20241017003136
Medical Identifiers
Medical identifiers for Dr Terri Ann Eubanks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306960737 | NPI | - | NPPES |
| 58142 | Other | AR | ARBCBS PROVIDER # |
| 833311 | Other | AR | UNITED CONCORDIA |
| 4025414 | Other | TN | BCBS OF TENN |
| 710748470 | Other | AR | FED TAX ID |
| 114704608 | Medicaid | AR | |
| 2854 | Other | AR | STATE LIC NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 2854 (Arkansas) | Primary |
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. Dr Terri Ann Eubanks allows following entities to bill medicare on her behalf.
| Entity Name | Mainline Health Systems, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164264834
PECOS PAC ID: 5193785590
Enrollment ID: O20041011000567 |
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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. Dr Terri Ann Eubanks 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 Terri Ann Eubanks, DDS
300 S School St,
Dermott, AR 71638-2127
Ph: (870) 538-9720 | Dr Terri Ann Eubanks, DDS
300 S School St,
Dermott, AR 71638-2127
Ph: (870) 538-9720 |
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