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Bethany K Tant

Dentist

Dental Providers

3160 Henderson Dr, Jacksonville, NC 28546-5248

PECOS Enrollment

This provider is enrolled in PECOS as BETHANY TANT.

Based on the most recent information from CMS, provider Bethany K Tant is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1588644611
Provider Type
Individual
Full Name
Tant, Bethany K
Credential
DDS

Gender
Female
Sole Proprietor
No
Enumeration Date
1/17/2006
Last Updated
7/2/2015

Contact Information

Practice Location

3160 Henderson Dr, Jacksonville, NC 28546-5248

(910) 346-5600

(910) 346-5396

Mailing Location

3160 Henderson Dr, Jacksonville, NC 28546-5248

(910) 346-5600

(910) 346-5396

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 7813 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 2060755	Description Other	Issuer UCCI North Carolina
ID 5908945	Description Medicaid	Issuer Unlisted North Carolina

Bethany K Tant

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Gabaree, Warren F

Dameworth, Taylor

Gilliam, Maxwell L

Karen J Armstrong Dmd & Bethany K Tant Dds Pllc

Williams, Michael Sean

Wilson, James R

Magleby, Benjamin Mithrandir

Michael S. Williams Dds, Pa

Morgan, Kimberly M

Fickey, Charlene Enolpe