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MICHAEL A DEROSE DDS PA
NPI 1457389108
Dentist - General Practice in Raleigh, NC

Active since June 30, 2006
3212 S WILMINGTON ST, RALEIGH, NC 27603(919) 773-3002(919) 773-8824 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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 1457389108) is a healthcare organization registered as a general practice in Raleigh, 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

NPI1457389108
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMICHAEL A DEROSE DDS PA
Location Address3212 S WILMINGTON STRaleigh, NC 27603-3538
Mailing Address2041 Silas Creek PkwyWinston Salem, NC 27103-5147 · (336) 777-0303 · Fax (336) 777-3448
Phone(919) 773-3002
Fax(919) 773-8824
Organization SubpartNo
Authorized OfficialMichael Anthony DeroseOwner · (336) 777-0303
Enumeration DateJune 30, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1457389108 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.
3212 S WILMINGTON ST, Raleigh, NC 27603
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Other Identifiers 2

Other012RVBlue Cross Blue Shield Nc
Medicaid89012RVNC

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 3

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

BRANDY THORNTON JOYNER DDS
Dentist (General Practice)
3212 S WILMINGTON ST
RALEIGH, NC 27603
Wake County (919) 773-3002
DR. LINDSAY ANDERSON STATILE DDS
Dentist (Pediatric Dentistry)
3212 S WILMINGTON ST
RALEIGH, NC 27603
Wake County (919) 773-3002
RAFAEL RIVERA, JR., DDS, PLLC
Dentist
3212 S WILMINGTON ST
RALEIGH, NC 27603
Wake County (919) 773-3002

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 1457389108. It was assigned to this organization in the NPPES registry on June 30, 2006.

Where is Michael A Derose Dds PA located?

Michael A Derose Dds PA is located at 3212 S Wilmington St, Raleigh, NC 27603. The listed phone number is (919) 773-3002.

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 August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.