Dilworth Dermatology and Laser, PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

DILWORTH DERMATOLOGY AND LASER, PLLC

Practice address

719 East Boulevard
Charlotte, NC 28203

Phone

(704) 376-9849

Fax

(704) 333-0708

NPI assigned

Dec 27, 2005

Last updated

Apr 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Denise Hudson, RN

Title

Office Manager

Phone

(704) 376-9849

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dermatologic Laser Center, PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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.

• Charles Jacob Brown, M.D.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1235155250
  Medicare reassignment Care Compare group NPD
• Katherine Christine Caggiano, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Charlotte, NC
  • NPI 1689746323
  Medicare reassignment Care Compare group
• Heather Holley Corbin, PA-C

  • Physician Assistant
  • Gastonia, NC
  • NPI 1528363264
  Medicare reassignment Care Compare group
• Danielle Tashakori, PA

  • Medical Physician Assistant
  • Charlotte, NC
  • NPI 1518217231
  Medicare reassignment Care Compare group
• Euphemia W Mu, M.D.

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
  • NPI 1245500545

  Dermatology

  Medicare reassignment NPD

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1417934001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 EAST BOULEVARD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28203",
            "telephone_number": "704-376-9849",
            "fax_number": "704-333-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 EAST BOULEVARD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28203",
            "telephone_number": "704-376-9849",
            "fax_number": "704-333-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILWORTH DERMATOLOGY AND LASER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-376-9849",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0229K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatologic Laser Center, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Stephanie Dillon, D.O.
• Shelley Kaye Dills, MS, CGC
• Matthew Clay Dillworth, LPC, NCC
• Diana Dilone Perez
• Mary E Dilorenzo, NP
• Dilworth Drugs, LLC (Dilworth Wellness Center)
• Dilworth Facial Plastic Surgery, PLLC
• Joaquin Cuevas Dimanlig
• Maria Mendoza Dimanlig, PT
• Kasondra Mae Dimarzo

• MOHS-Micrographic Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• MOHS-Micrographic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.