Tanner Gustafson
NPI 1669049821ActiveIndividual· Dentist, General Practice· Beaufort, SC
Dentist, General Practice in Beaufort, South Carolina, licensed in SC and GA, with an NPI issued in June 2021. Part D covered 53 prescriptions written in 2024, 89% of them generic.
Overview
| NPI | 1669049821 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jun 7, 2021 |
| Last updated in NPPES | May 3, 2023 |
| Certified by provider | May 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 10270 | SC |
| Dentist | 122300000X | DN122359 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 53 · 53 30-day fills |
|---|---|
| Patients | 36 |
| Total drug cost | $156.76 |
| Generic share | 89% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 60 general dentists in Beaufort · All general dentists in South Carolina