Active NPI
Valleygate Dental Surgery Center of Charlotte LLC
- Ambulatory Surgical Clinic/Center
- Charlotte, NC
National Provider Identifier
1043191661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC
- Practice address
- 13515 Steele Creek Rd
Charlotte, NC 28273-0088 - Phone
- (910) 485-7070
- Fax
- (910) 500-6972
- NPI assigned
- Sep 10, 2025
- Organization subpart
- Yes
- Parent organization
- VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Digiacomo
- Title
- Revenue Cycle Manager
- Phone
- (910) 406-9455
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | |||
| Pediatric Anesthesiology Physician | 207LP3000X | |||
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
13515 Steele Creek Rd
Charlotte, NC 28273-0088
Mailing address
13515 Steele Creek Rd
Charlotte, NC 28273-6839
Phone (910) 485-7070
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2332861 | Valleygate Dental Surgery Center of Charlotte, LLC | Certificate of waiver | Oct 26, 2027 |
National Provider Directory
National Provider Directory- Part of
- Valleygate Dental Surgery Center of Charlotte LLC
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Ambulatory Surgical Clinic/Center
- Charlotte, NC
- NPI 1720573587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757462400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782259200000",
"number": "1043191661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13515 STEELE CREEK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282736839",
"telephone_number": "910-485-7070",
"fax_number": "910-500-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13515 STEELE CREEK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282730088",
"telephone_number": "910-485-7070",
"fax_number": "910-500-6972"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC",
"enumeration_date": "2025-09-10",
"last_updated": "2026-06-24",
"certification_date": "2026-06-24",
"status": "A",
"authorized_official_last_name": "DIGIACOMO",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
"authorized_official_telephone_number": "910-406-9455"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.