Donald Richard Demichele II, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

11389 Issued in NC

Practice address

BLDG H-3817 Gruber Rd
Fort Bragg, NC 28310-4095

Phone

(910) 396-1572

NPI assigned

Jul 31, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647129600000",
    "number": "1194379891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13110 QUARTERHORSE RUN",
            "city": "ROUGEMONT",
            "state": "NC",
            "postal_code": "275729342",
            "telephone_number": "208-477-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG H-3817 GRUBER RD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283104095",
            "telephone_number": "910-396-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMICHELE",
        "first_name": "DONALD",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2022-03-13",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Dekow, D.M.D., MBE
• Mary Rose Del Carmen, PT, DPT
• Zach A Delabastide, PA-C
• Daniella Delacruz, DMD
• Katherine Ann Demers, P.A.
• Jennifer Lauren Dempsey, PA
• Emma Denmark, PA
• Gerald Douglas Depold
• Nicholas Derfler
• Raffaella Derosa, M.D.

• Dentist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.