VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC (NPI# 1003321365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003321365 |
| Entity Type | Organization |
| Organization Name | VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC |
| Other Organization Name | VALLEYGATE DENTAL SURGERY CENTER |
| Practice Address |
2038 Litho Place Fayetteville NC 28304 |
| Mailing Address |
2028 Litho Pl Ste 300 Fayetteville NC 28304-2538 |
| Practice Telephone | 9104857070 |
| Practice Fax Number | 9104851151 |
| Mailing Telephone | 9104857070 |
| Mailing Fax Number | 9104851151 |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2019-10-25 |
| Authorized Official Name | MRS. VIRGINIA JONES (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9104857070 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
Dental Providers | ||
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers | ||
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| N | 1223X0008X |
Dentist Specialization: Oral and Maxillofacial Radiology |
Dental Providers | ||
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
Nursing Service Providers | ||
| N | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Valleygate Dental Surgery Center | Doing Business As Name - Organization |
| Street Address |
2038 LITHO PLACE |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093215147 | Valleygate Anesthesia | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2018-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| 1760911028 | Gabrielle Wheat | Social Worker | 2211 Hope Mills Road, Fayetteville, NC 28304 | 2017-06-08 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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| 1477178879 | Surgcenter of Fayetteville, LLC | Clinic/Center | 1905 E Mission Blvd Ste 5, Fayetteville, AR 72703-3129 | 2020-06-11 |
| 1750905618 | Rsps Fayetteville Asc Lllp | Clinic/Center | 874 Lanier Ave W Ste 270, Fayetteville, GA 30214-7617 | 2020-06-05 |
| 1396298139 | Resurgens Fayette Surgery Center, LLC | Clinic/Center | 1336 Highway 54 W Bldg 400, Fayetteville, GA 30214-4535 | 2016-07-28 |
| 1447630876 | Ortho Atlanta Surgery Center of Fayetteville | Clinic/Center | 1265 Highway 54 W Ste 103, Fayetteville, GA 30214-4537 | 2015-06-01 |
| 1801196050 | Agcny East LLC | Clinic/Center | Northeast Medical Building Condominium, Suite 308, Fayetteville, NY 13066-6638 | 2010-10-21 |
| 1265679674 | Georgia Urology Fayette Asc | Clinic/Center | 140 Carnegie Pl, Suite 108, Fayetteville, GA 30214-7913 | 2009-01-07 |
| 1093907339 | Taylor Surgery Center, LLC | Clinic/Center | 3733 N Business Dr Ste 101, Fayetteville, AR 72703-5286 | 2007-08-10 |
| 1386737021 | Arkansas Outpatient Eye Surgery LLC | Clinic/Center | 3689 N Steele Blvd, Fayetteville, AR 72703-5347 | 2006-10-02 |
| 1033154364 | Paula Pons Physician LLC | Clinic/Center | 4206 Medical Center Dr Ste 203, Fayetteville, NY 13066 | 2006-06-19 |
| 1285622845 | Physicians' Surgery Center of Fayetteville, LLC | Clinic/Center | 3733 N Business Dr, Suite #101, Fayetteville, AR 72703-5203 | 2005-10-07 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.