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MICHAEL A DEROSE DDS PA
NPI 1164467411
Dentist - General Practice in Winston Salem, NC

Active since June 19, 2006
2041 SILAS CREEK PKWY, WINSTON SALEM, NC 27103(336) 777-0303(336) 777-3448 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Michael A Derose Dds Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL A DEROSE DDS PA (NPI 1164467411) is a healthcare organization registered as a general practice in Winston Salem, North Carolina and active in the NPI registry since June 2006. The organization lists Michael Anthony Derose, Owner, as its authorized official.

NPPES Registry Identity

NPI1164467411
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMICHAEL A DEROSE DDS PA
Location Address2041 SILAS CREEK PKWYWinston Salem, NC 27103-5147
Mailing Address2041 Silas Creek PkwyWinston Salem, NC 27103-5147 · (336) 777-0303 · Fax (336) 777-3448
Phone(336) 777-0303
Fax(336) 777-3448
Organization SubpartNo
Authorized OfficialMichael Anthony DeroseOwner · (336) 777-0303
Enumeration DateJune 19, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1164467411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2041 SILAS CREEK PKWY, Winston Salem, NC 27103
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Other Identifiers 2

Medicaid89012P6NC
Other012P6Blue Cross Blue Shield Nc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANTWAN DEVON BATES D.D.S.
Dentist
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
RAFAEL RIVERA, JR., DDS, PLLC
Dentist
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
DR. CHARLES NOEL KIDROSKE DDS
Dentist (General Practice)
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
EDWARD MOSELY TOWNES III DDS
Dentist (General Practice)
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
SCOTT ALAN FOLSOM DMD
Dentist (General Practice)
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
MICHELLE CHRISTINE STOFFA DDS
Dentist (General Practice)
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
JANICE D CLARK D.D.S.
Dentist (General Practice)
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272
NADIA SIDDIQUI D.D.S.
Dentist
2041 SILAS CREEK PKWY
WINSTON SALEM, NC 27103
Forsyth County (336) 777-1272

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael A Derose Dds PA's NPI number?

The NPI number for Michael A Derose Dds PA is 1164467411. It was assigned to this organization in the NPPES registry on June 19, 2006.

Where is Michael A Derose Dds PA located?

Michael A Derose Dds PA is located at 2041 Silas Creek Pkwy, Winston Salem, NC 27103. The listed phone number is (336) 777-0303.

What is Michael A Derose Dds PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Michael A Derose Dds PA was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.