Organization Active NPI

Valleygate Dental Surgery Center of Charlotte LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
National Provider Identifier
1043191661
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
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 LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pediatric Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2332861Valleygate Dental Surgery Center of Charlotte, LLC13515 Steele Creek Rd, Charlotte, NC 28273Certificate of waiverOct 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.

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.

Verify at the official NPI Registry.