VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE LLC NPI 1003321365

NPI Information

NPI: 1003321365
Provider Name: VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC

Doing Business As: VALLEYGATE DENTAL SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2038 LITHO PLACE
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 485-7070
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VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC is an ambulatory surgical clinic center in Fayetteville, NC. VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC NPI is 1003321365. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Valleygate Dental Surgery Center.

The provider's business location address is:

2038 LITHO PLACE
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 485-7070
Fax: (910) 485-1151

The provider's authorized official is Virginia Jones .
The authorized official title is Chief Executive Officer and has the following contact phone number (910) 485-7070.

The enumeration date for this NPI number is 12/8/2017 and was last updated on 10/25/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	1223D0004X	Dentist	Dentist Anesthesiologist	No
2	1223E0200X	Dentist	Endodontics	No
3	1223P0106X	Dentist	Oral and Maxillofacial Pathology	No
4	1223P0221X	Dentist	Pediatric Dentistry	No
5	1223P0300X	Dentist	Periodontics	No
6	1223S0112X	Dentist	Oral and Maxillofacial Surgery	No
7	1223X0008X	Dentist	Oral and Maxillofacial Radiology	No
8	163WP0200X	Registered Nurse	Pediatrics	No
9	204E00000X	Oral & Maxillofacial Surgery		No
10	207L00000X	Anesthesiology		No
11	2086S0127X	Surgery	Trauma Surgery	No
12	261QA1903X	Clinic/Center	Ambulatory Surgical	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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