DILWORTH DERMATOLOGY AND LASER, PLLC
NPI 1417934001
Dermatology - MOHS-Micrographic Surgery in Charlotte, NC

Q: What is Dilworth Dermatology And Laser, PLLC's NPI number?

The NPI number for Dilworth Dermatology And Laser, PLLC is 1417934001. It was assigned to this organization in the NPPES registry on December 27, 2005. The provider was formerly known as Dermatologic Laser Center, PLLC.

Q: What is Dilworth Dermatology And Laser, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Active since December 27, 2005CLIA 34D0244133 · Certificate of Compliance

719 EAST BOULEVARD, CHARLOTTE, NC 28203(704) 376-9849(704) 333-0708 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 16, 2024, Apr 12, 2024, Jun 30, 2016 (3 updates tracked since 2016).

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About Dilworth Dermatology And Laser, Pllc NPPES

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

DILWORTH DERMATOLOGY AND LASER, PLLC (NPI 1417934001), doing business as Dermatologic Laser Center, Pllc, is a healthcare organization registered as a mohs-micrographic surgery in Charlotte, North Carolina and active in the NPI registry since December 2005. The organization holds a CLIA Certificate of Compliance certificate valid through December 2, 2026 and lists Denise Hudson, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1417934001

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameDILWORTH DERMATOLOGY AND LASER, PLLC

Location Address719 EAST BOULEVARDCharlotte, NC 28203

Mailing Address719 East BoulevardCharlotte, NC 28203 · (704) 376-9849 · Fax (704) 333-0708

Phone(704) 376-9849

Fax(704) 333-0708

Organization SubpartNo

Authorized OfficialDenise HudsonOffice Manager · (704) 376-9849

Enumeration DateDecember 27, 2005

Last NPPES UpdateApril 16, 20243 updates tracked since enumeration

NPPES CertifiedApril 16, 2024

✔ NPI 1417934001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

Definition

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.

719 EAST BOULEVARD, Charlotte, NC 28203

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Other Names 1

Former Legal Business NameDermatologic Laser Center, Pllc

Other Identifiers 1

Other0229KNC · Bcbs

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dilworth Dermatology And Laser, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Dilworth Dermatology And Laser, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Charles Brown, M.D.

Dermatology

NPI 1235155250

719 EAST BOULEVARD
Charlotte, NC 28203

(704) 376-9849

✔ PECOS✔ Accepts MedicareSame address

Euphemia Mu, M.D.

Micrographic Dermatologic Surgery (MDS)

NPI 1245500545

8936 BLAKENEY PROFESSIONAL DR
Charlotte, NC 28277

(704) 943-3714

✔ PECOS✔ Accepts Medicare12 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 34D0244133

Dilworth Dermatology · Charlotte, NC

Active · expires Dec 2, 2026

CLIA Number34D0244133

Laboratory TypePhysician Office

Certificate Effective DateDecember 3, 2024

Certificate Expiration DateDecember 2, 2026

Laboratory DirectorCharles Brown

Laboratory Phone(704) 376-9849

Laboratory LocationDilworth Dermatology719 East Boulevard, Charlotte, NC 28203

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Dilworth Dermatology And Laser, PLLC's NPI number?

The NPI number for Dilworth Dermatology And Laser, PLLC is 1417934001. It was assigned to this organization in the NPPES registry on December 27, 2005. The provider was formerly known as Dermatologic Laser Center, PLLC.

Where is Dilworth Dermatology And Laser, PLLC located?

Dilworth Dermatology And Laser, PLLC is located at 719 East Boulevard, Charlotte, NC 28203. The listed phone number is (704) 376-9849.

What is Dilworth Dermatology And Laser, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Dilworth Dermatology And Laser, PLLC enrolled in Medicare?

Yes. Dilworth Dermatology And Laser, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dilworth Dermatology And Laser, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Dilworth Dermatology And Laser, PLLC, in Dermatology and Micrographic Dermatologic Surgery (MDS). A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dilworth Dermatology And Laser, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 34D0244133) is associated with this NPI, valid through December 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dilworth Dermatology And Laser, PLLC was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.