Dr Tristan Cordray, DMD is a medicare enrolled "Dentist" provider in Saint Stephen, South Carolina. His current practice location is
1142 S Main St, Saint Stephen, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(843) 567-2900.
Dr Tristan Cordray is licensed to practice in South Carolina (license number 4328) 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 1619171170.
Healthcare Provider's Profile
Full Name | Dr Tristan Cordray |
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Gender | Male |
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Speciality | Dentist |
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Location | 1142 S Main St, Saint Stephen, South Carolina |
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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: 1619171170
- Provider Enumeration Date: 06/11/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5597085597
- Enrollment ID: I20150514001379
Medical Identifiers
Medical identifiers for Dr Tristan Cordray such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619171170 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 4328 (South Carolina) | Primary |
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 Tristan Cordray 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 Tristan Cordray, DMD 56 Colleton Dr, Charleston, SC 29407-7301 Ph: (843) 209-7334 | Dr Tristan Cordray, DMD 1142 S Main St, Saint Stephen, SC 29479-3996 Ph: (843) 567-2900 |
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