MICHAEL A DEROSE DDS PA (NPI# 1598700775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598700775 |
| Entity Type | Organization |
| Organization Name | MICHAEL A DEROSE DDS PA |
| Practice Address |
4901 N Tryon St Charlotte NC 28213-7033 |
| Mailing Address |
2041 Silas Creek Pkwy Winston Salem NC 27103-5147 |
| Practice Telephone | 7049210204 |
| Practice Fax Number | 7049214095 |
| Mailing Telephone | 3367770303 |
| Mailing Fax Number | 3367773448 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL ANTHONY DEROSE (OWNER) |
| Authorized Official Telephone | 3367770303 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89014NG | 05 | |
| BLUE CROSS BLUE SHIELD NC | 014NG | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457389108 | Michael A Derose Dds Pa | Dentist | 3212 S Wilmington St, Raleigh, NC 27603-3538 | 2006-06-30 |
| 1598793242 | Michael A Derose Dds Pa | Dentist | 3053 Freedom Dr Ste B, Charlotte, NC 28208-3862 | 2006-06-30 |
| 1164467411 | Michael A Derose Dds Pa | Dentist | 2041 Silas Creek Pkwy, `, Winston Salem, NC 27103-5147 | 2006-06-19 |
| Street Address |
4901 N TRYON ST |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28213-7033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912427 | Rafael Rivera Jr. | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2005-06-14 |
| 1871800979 | Dipti V. Patel | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7076 | 2010-09-10 |
| 1396057006 | Julie Custred Spivey | Dentist | 4901 N Tryon St, Unit A, Charlotte, NC 28213-7076 | 2010-07-10 |
| 1912230236 | Sarah Catherine Williamson | Dentist | 4901 N Tryon St, Suite A, Charlotte, NC 28213-7076 | 2009-09-18 |
| 1265667000 | Ashley Hunt Chandler | Dentist | 4901 N Tryon St, Charlotte, Charlotte, NC 28213-7076 | 2009-05-22 |
| 1194994004 | Rafael Rivera, Jr, Dds, Pllc | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2008-02-25 |
| 1902918444 | Kimberly Joi Minor | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2006-08-31 |
| 1134237878 | Jeffrey Frank Zieziula | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2006-08-25 |
| 1386752061 | Frank Kendrick | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2006-08-25 |
| 1386752046 | Catherine Kim Schneider | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2006-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1447743331 | April Neville | Counselor | 2442 Ryerson Ct, Charlotte, NC 28213 | 2018-06-14 |
| 1194234328 | Specialized Health Care Services | Case Management | 2750 E. Wt Harris Blvd, Suite 128, Charlotte, NC 28213 | 2017-09-19 |
| 1871016816 | Monarch | Occupational Therapist | 1810 Back Creek Drive, Charlotte, NC 28213 | 2017-07-21 |
| 1609306778 | Mackenzie Cashman Precht | Physician Assistant | 2225 E W T Harris Blvd Unit B, Charlotte, NC 28213 | 2017-06-12 |
| 1861939118 | Nensi Pandya | Pharmacist | 10227 University City Blvd, Charlotte, NC 28213 | 2017-01-25 |
| 1952721458 | Morgan Washington | Specialist/Technologist | 2336 Comfrey Court, Charlotte, NC 28213 | 2014-04-23 |
| 1992132393 | Midway Healthcare | Home Health | 6003 Dovetree Lane Suite D, Charlotte, NC 28213 | 2013-09-30 |
| 1932445178 | Zachary Gachogu Kariuki | Counselor | 10417 Round Leaf Drive, Charlotte, NC 28213 | 2012-12-17 |
| 1962747675 | Crystal Cherie Simmons | Counselor | 13724 Riding Hill Ave, Charlotte, NC 28213 | 2012-12-06 |
| Find all providers in zip 28213 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851805 | Ganglani Dmd Pllc | Dentist | 8420 Park Rd, Charlotte, NC 28210-5801 | 2020-08-10 |
| 1598381816 | Robert Edwin Porter | Dentist | 135 S Sharon Amity Rd Ste 200, Charlotte, NC 28211-3871 | 2020-06-23 |
| 1811511165 | Cameron Campbell | Dentist | 2315 W Arbors Dr Ste 220, Charlotte, NC 28262-2639 | 2020-06-02 |
| 1407479264 | Darren Ramsey Dds Pllc | Dentist | 2748 Interstate St Ste C, Charlotte, NC 28208-3654 | 2020-05-27 |
| 1265052070 | Alterman Dhillon and Associates | Dentist | 4815 Berewick Town Center Dr Ste I&j, Charlotte, NC 28278-6733 | 2020-04-22 |
| 1982234357 | S. Gibree, D.m.d., P.C. | Dentist | 8680 Rachel Freeman Way Ste A, Charlotte, NC 28278-9567 | 2020-01-24 |
| 1093354854 | S. Gibree, D.m.d., P.C. | Dentist | 9511 Riverbend Village Dr Ste I5, Charlotte, NC 28216-9124 | 2019-12-27 |
| 1063057479 | Justin Harlow Dds Pa 2 | Dentist | 2607 E 7th St Ste 102, Charlotte, NC 28204-4308 | 2019-11-08 |
| 1336782192 | David Hendrick Dds Pllc IIi | Dentist | 13739 Steele Creek Rd Unit 100, Charlotte, NC 28273-7139 | 2019-10-24 |
| 1891342119 | Natasha Mofrad | Dentist | 3210 Wilkinson Blvd, Charlotte, NC 28208-5661 | 2019-08-21 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on MICHAEL A DEROSE DDS PA.
| 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.