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RAYNALD L. DESAMEAU DMD PLLC III
NPI 1396567095
Dentist - Pediatric Dentistry in Charlotte, NC

Active since October 25, 2024
10460 PARK ROAD, CHARLOTTE, NC 28210(704) 540-5440 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Raynald L. Desameau Dmd Pllc Iii NPPES

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

RAYNALD L. DESAMEAU DMD PLLC III (NPI 1396567095), doing business as Coral Reef Pediatric Dentistry, is a healthcare organization registered as a pediatric dentistry in Charlotte, North Carolina and active in the NPI registry since October 2024. The organization lists Raynald Leon Desameau, Owner/member, as its authorized official.

NPPES Registry Identity

NPI1396567095
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameRAYNALD L. DESAMEAU DMD PLLC III
Location Address10460 PARK ROADCharlotte, NC 28210
Mailing Address10460 Park RoadCharlotte, NC 28210
Phone(704) 540-5440
Organization SubpartNo
Authorized OfficialRaynald Leon DesameauOwner/member · (912) 332-3932
Enumeration DateOctober 25, 2024
NPPES CertifiedOctober 22, 2024
✔ NPI 1396567095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
10460 PARK ROAD, Charlotte, NC 28210
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Other Names 1

Doing Business AsCoral Reef Pediatric Dentistry

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

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 Raynald L. Desameau Dmd PLLC III's NPI number?

The NPI number for Raynald L. Desameau Dmd PLLC III is 1396567095. It was assigned to this organization in the NPPES registry on October 25, 2024. The provider is doing business as Coral Reef Pediatric Dentistry.

Where is Raynald L. Desameau Dmd PLLC III located?

Raynald L. Desameau Dmd PLLC III is located at 10460 Park Road, Charlotte, NC 28210. The listed phone number is (704) 540-5440.

What is Raynald L. Desameau Dmd PLLC III's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Raynald L. Desameau Dmd PLLC III accept?

Health plans from Blue Cross and Blue Shield of NC list Raynald L. Desameau Dmd PLLC III as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raynald L. Desameau Dmd PLLC III was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.