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Organization

VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VIRGINIA T JONES MAC, PHD (CEO)
(910) 485-7070
Entity
Organization

Contact information

Practice address
8415 MEDICAL PLAZA DR, CHARLOTTE, NC 28262-9768
(910) 485-7070
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
1223E0200X
Endodontics
1223P0106X
Oral and Maxillofacial Pathology Dentistry
1223P0221X
Pediatric Dentistry
1223P0300X
Periodontics
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1223X0008X
Oral and Maxillofacial Radiology Dentistry
163WP0200X
Pediatric Registered Nurse
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2086S0127X
Trauma Surgery Physician
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
363AM0700X
Medical Physician Assistant

Other

Enumeration date
06/25/2018
Last updated
10/09/2025
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