# VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043191661
- **Legal business name:** VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC
- **Authorized official:** JENNIFER DIGIACOMO (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (910) 406-9455

## Contact information

- **Practice address:** 13515 STEELE CREEK RD, CHARLOTTE, NC 28273-0088
- **Practice address phone:** (910) 485-7070
- **Practice address fax:** (910) 500-6972
- **Mailing address:** 13515 STEELE CREEK RD, CHARLOTTE, NC 28273-6839
- **Mailing address phone:** (910) 485-7070
- **Mailing address fax:** (910) 500-6972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP3000X | Pediatric Anesthesiology Physician | — | NULL | — |
| 207LP3000X | Pediatric Anesthesiology Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/10/2025
- **Last updated:** 06/24/2026