NPIMap

Organization Active NPI

Tadrissi DDS, PLLC

Doing business as Queen City Endodontics - Lake Norman

  • Endodontics
  • Mooresville, NC
National Provider Identifier
1255818944
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
TADRISSI DDS, PLLC
Doing business as
Queen City Endodontics - Lake Norman
Practice address
150 Professional Park Dr Ste 100
Mooresville, NC 28117-5604
Phone
(704) 799-6979
Fax
(704) 536-5998
NPI assigned
Jul 25, 2018
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Michaela Muniz
Title
VP, Payor Relations
Phone
(469) 324-3242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

150 Professional Park Dr Ste 100
Mooresville, NC 28117-5604

Mailing address

150 Professional Park Dr Ste 100
Mooresville, NC 28117-5604
Phone (704) 799-6979

Other names 1

  • Queen City Endodontics - Lake Norman Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tadrissi DDS PLLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5232 Albemarle Rd
Ste C
Charlotte, NC 28212
Phone (704) 536-6774

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1255818944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PROFESSIONAL PARK DR STE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175604",
            "telephone_number": "704-799-6979",
            "fax_number": "704-536-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PROFESSIONAL PARK DR STE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175604",
            "telephone_number": "704-799-6979",
            "fax_number": "704-536-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TADRISSI DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-25",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "VP, PAYOR RELATIONS",
        "authorized_official_telephone_number": "469-324-3242"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queen City Endodontics - Lake Norman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.