Dr Theresa Sullivan Gonzales, DMD, MS in Charleston, SC

Dr Theresa Sullivan Gonzales, DMD, MS is a medicare enrolled "Dentist - Oral And Maxillofacial Pathology" provider in Charleston, South Carolina. Her current practice location is 173 Ashley Avenue Msc 507, Charleston, South Carolina. You can reach out to her office (for appointments etc.) via phone at (843) 792-8723.

Dr Theresa Sullivan Gonzales is licensed to practice in South Carolina (license number 2648) 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 1912969502.

Contact Information

	Dr Theresa Sullivan Gonzales, DMD, MS
	173 Ashley Avenue Msc 507, Charleston, SC 29401
	(843) 792-8723
	(843) 792-3697

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Theresa Sullivan Gonzales
Gender	Female
Speciality	Dentist - Oral And Maxillofacial Pathology
Location	173 Ashley Avenue Msc 507, Charleston, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912969502
Provider Enumeration Date: 04/06/2006
Last Update Date: 08/31/2016

Medicare PECOS Information:

PECOS PAC ID: 3375760093
Enrollment ID: I20141219001365

Medical Identifiers

Medical identifiers for Dr Theresa Sullivan Gonzales such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912969502	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223P0106X	Dentist - Oral And Maxillofacial Pathology	17566 (Texas)	Secondary
1223P0106X	Dentist - Oral And Maxillofacial Pathology	2648 (South Carolina)	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 Theresa Sullivan Gonzales allows following entities to bill medicare on her behalf.

Entity Name	University Medical Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043241110 PECOS PAC ID: 6305758574 Enrollment ID: O20031105000291

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 Theresa Sullivan Gonzales 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 Theresa Sullivan Gonzales, DMD, MS Po Box 751461, Charlotte, NC 28275-1461 Ph: (843) 792-6200	Dr Theresa Sullivan Gonzales, DMD, MS 173 Ashley Avenue Msc 507, Charleston, SC 29401 Ph: (843) 792-8723

Reviews and Comments

Dentist in Charleston, SC

Dr. Mary Victoria Tatum, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 92 Courtenay Dr, Charleston, SC 29403 Phone: 843-577-6112 Fax: 843-937-0200
Adam M Clark, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1416 Ashley River Rd, Atlantic Aesthetics, Charleston, SC 29407 Phone: 843-769-0488 Fax: 843-769-0428
Dr. James Randall Marshall, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 29 Bee Street, Dc 500, Charleston, SC 29425 Phone: 843-792-1904 Fax: 843-792-2212
Dr. Fabio Rizzante, DDS, MSC, PHD, MBA Dentist Medicare: Not Enrolled in Medicare Practice Location: 29 Bee Street, Charleston, SC 29425 Phone: 734-489-2834
Dr. James Elliott Gregory Jr., DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1812 Wallace School Rd, Charleston, SC 29407 Phone: 843-571-4411
Dr. Robert Louis Morrow Sr., DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 18 A Leinbach Dr., Charleston, SC 29407 Phone: 843-795-3339
Dr. James J Richart, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1164a Northbridge Drive, Charleston, SC 29407 Phone: 843-852-3401 Fax: 843-852-3402

Dr Theresa Sullivan Gonzales, DMD, MS - Medicare Dentist in Charleston, SC