Su Mei Mai, in Fort Irwin, CA - Medicare Dentist Provider

Su Mei Mai, is a medicare enrolled "Dentist" provider in Fort Irwin, California. Her current practice location is 3745 Fredricksburg St Apt B, Fort Irwin, California. You can reach out to her office (for appointments etc.) via phone at (270) 798-8751.

Su Mei Mai is licensed to practice in California (license number 101839) 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 1487179743.

Contact Information

	Su Mei Mai,
	3745 Fredricksburg St Apt B, Fort Irwin, CA 92310-1701
	(270) 798-8751
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Su Mei Mai
Gender	Female
Speciality	Dentist
Location	3745 Fredricksburg St Apt B, Fort Irwin, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487179743
Provider Enumeration Date: 08/08/2017
Last Update Date: 03/18/2021

Medicare PECOS Information:

PECOS PAC ID: 8224412796
Enrollment ID: I20220901000522

Medical Identifiers

Medical identifiers for Su Mei Mai such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487179743	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	101839 (California)	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. Su Mei Mai allows following entities to bill medicare on her behalf.

Entity Name	Kwon Dds Professional Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881021434 PECOS PAC ID: 5698159283 Enrollment ID: O20220831001246

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. Su Mei Mai 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
Su Mei Mai, 3745 Fredricksburg St Apt B, Fort Irwin, CA 92310-1701 Ph: (270) 798-8751	Su Mei Mai, 3745 Fredricksburg St Apt B, Fort Irwin, CA 92310-1701 Ph: (270) 798-8751

Reviews and Comments

Dentist in Fort Irwin, CA

Dr. Stephanie Chung Lee, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Road, Fort Irwin, CA 92310 Phone: 760-380-3166
Ryan Steven Payne, Dentist Medicare: Not Enrolled in Medicare Practice Location: 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 Phone: 719-526-5537 Fax: 706-787-2082
Dr. Brent Wayne Clark, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 390 North Loop Rd., Fort Irwin, CA 92310 Phone: 760-383-5289
Dr. Joshua Hyungkyu Lee, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4th And Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 Phone: 719-526-5537
Dr. Yong Soo Kim, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-3166
Dr. Sergio Hernandez, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-3173
Dr. Dolores Luque, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: Building 171, 4th & Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-5733 Fax: 760-380-4996

Su Mei Mai, - Medicare Dentist in Fort Irwin, CA