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Organization
VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC
Active
Organization
VALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC
Active
Other names
Valleygate Dental Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINIA JONES (CHIEF EXECUTIVE OFFICER)
(910) 485-7070
Entity
Organization
Contact information
Practice address
2038 LITHO PLACE, FAYETTEVILLE, NC 28304
(910) 485-7070
(910) 485-1151
Mailing address
2028 LITHO PL STE 300, FAYETTEVILLE, NC 28304-2538
(910) 485-7070
(910) 485-1151
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
—
NULL
1223D0004X
Dental Anesthesiology
—
—
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NULL
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
NULL
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
163WP0200X
Pediatric Registered Nurse
—
NULL
163WP0200X
Pediatric Registered Nurse
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
2086S0127X
Trauma Surgery Physician
—
NULL
2086S0127X
Trauma Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/08/2017
Last updated
08/01/2025
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