Valleygate Dental Surgery Center of Charlotte LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC

Practice address

8415 Medical Plaza Dr
Charlotte, NC 28262-9768

Phone

(910) 485-7070

NPI assigned

Jun 25, 2018

Last updated

Oct 9, 2025By 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. Virginia T Jones, MAC, PHD

Title

Ceo

Phone

(910) 485-7070

Specialties & licenses 12

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720573587. Details of each certification follow.

• CCN 34C0001206 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 34C0001206

Legal name

VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

May 6, 2019

Last certification

May 1, 2019

Ownership / control type

Proprietary

Facility address

8415 Medical Plaza Drive
Charlotte, NC 28262

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

CLIA laboratory certificates

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Valleygate Dental Surgery Center of Charlotte LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1043191661
  NPPES parent name

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.

• Daniel R Cook, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Concord, NC
  • NPI 1417123456
  NPD (past)
• Camilla L Miskovich, D.M.D

  • Pediatric Dentistry
  • Matthews, NC
  • NPI 1013398783
  NPD (past)

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1720573587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 LITHO PL STE 300",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042538",
            "telephone_number": "910-485-7070",
            "fax_number": "910-485-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 MEDICAL PLAZA DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629768",
            "telephone_number": "910-485-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-485-7070",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MAC, PHD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Francis Valeriano, DDS
• Cole H Valko, D.C.
• Indira Valladares
• Val Pierre Vallat, M.D.
• Valleygate Dental Surgery Center of Charlotte LLC
• Neelima Valluru, M.B.B.S
• Danielle Valoras
• Vladislav Valtsis, D.O.
• Valued Home Care LLC
• Hernan Valverde

• Ambulatory Surgical Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.