DILWORTH DERMATOLOGY AND LASER, PLLC
NPI 1417934001
Dermatology - MOHS-Micrographic Surgery in Charlotte, NC
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- CLIA Number: 34D0244133
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-02-2026
About DILWORTH DERMATOLOGY AND LASER, PLLC
This page provides the complete NPI Profile along with additional information for Dilworth Dermatology And Laser, Pllc, a provider established in Charlotte, North Carolina operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1417934001 assigned on December 2005. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Dilworth Dermatology And Laser, Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's former legal business name is Dermatologic Laser Center, Pllc. The authorized official of this NPI record is Mrs. Denise Hudson Rn (Office Manager)
- NPI
- 1417934001 Verify this NPI
- Provider Legal Name
- DILWORTH DERMATOLOGY AND LASER, PLLC
- Other Organization Name
- DERMATOLOGIC LASER CENTER, PLLC
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 719 EAST BOULEVARD CHARLOTTE, NC 28203
- Location Phone
- (704) 376-9849
- Location Fax
- (704) 333-0708
- Mailing Address
- 719 EAST BOULEVARD CHARLOTTE, NC 28203
- Mailing Phone
- (704) 376-9849
- Mailing Fax
- (704) 333-0708
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-27-2005
- Last Update Date
- 04-16-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0229K | OTHER (01) | NC | BCBS |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D0244133
- Facility Type
- Physician Office
- Certificate Effective Date
- December 03, 2024
- Certificate Expiration Date
- December 02, 2026
- Laboratory Director
- CHARLES BROWN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Dilworth Dermatology And Laser, Pllc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417934001, enumerated as an "organization" on December 27, 2005.
The provider is located at 719 EAST BOULEVARD CHARLOTTE, NC 28203 and the phone number is (704) 376-9849.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
