ANTHONY R. IMMEDIATA D.M.D P.A. NPI 1861643678

NPI Information

NPI: 1861643678
Provider Name: ANTHONY R. IMMEDIATA, D.M.D, P.A.
Classification: Dentist - 1223S0112X
Specialization: Oral and Maxillofacial Surgery
Entity Type: Organization
Address: 7101 CREEDMOOR RD
SUITE 109
RALEIGH, NC
ZIP 27613
Phone: (919) 846-5500

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NPI Details

ANTHONY R. IMMEDIATA, D.M.D, P.A. is an oral and maxillofacial surgery dentist in Raleigh, NC. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ANTHONY R. IMMEDIATA, D.M.D, P.A. NPI is 1861643678. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7101 CREEDMOOR RD
SUITE 109
RALEIGH, NC
ZIP 27613-682
Phone: (919) 846-5500
Fax: (919) 846-7964

The provider's authorized official is Barbara Sed .
The authorized official title is Office Manager and has the following contact phone number (919) 846-5500.

The enumeration date for this NPI number is 10/10/2008 and was last updated on 12/3/2008.

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	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	5022	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8994426	MEDICAID	NORTH CAROLINA
2	2340076	MEDICARE PIN	NORTH CAROLINA

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: 11/21/2025

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