1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Specialist
  6. NPI Profile

ESTHETICS CENTER FOR DERMATOLOGY PA
NPI 1891879615
Specialist in Charlotte, NC

Active since October 25, 2006CLIA 34D1052338 · Microscopy
353 CLEMENT AVE, CHARLOTTE, NC 28204(704) 370-2700(704) 370-2702 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Esthetics Center For Dermatology Pa NPPES

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

ESTHETICS CENTER FOR DERMATOLOGY PA (NPI 1891879615) is a healthcare organization registered as a specialist in Charlotte, North Carolina and active in the NPI registry since October 2006. The organization holds a CLIA Microscopy certificate valid through March 22, 2028 and lists Peggy A. Fuller, Owner, as its authorized official.

NPPES Registry Identity

NPI1891879615
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameESTHETICS CENTER FOR DERMATOLOGY PA
Location Address353 CLEMENT AVECharlotte, NC 28204-2431
Mailing Address353 Clement AveCharlotte, NC 28204-2431 · (704) 370-2700 · Fax (704) 370-2702
Phone(704) 370-2700
Fax(704) 370-2702
Organization SubpartNo
Authorized OfficialPeggy A. FullerOwner · (704) 370-2700
Enumeration DateOctober 25, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1891879615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NC · 127728
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

353 CLEMENT AVE, Charlotte, NC 28204
Open in Google Maps ↗

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

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 for Provider-Performed Microscopy Procedures (PPMP) 34D1052338

Esthetics-Center For Dermatology · Charlotte, NC
Active · expires Mar 22, 2028
CLIA Number34D1052338
Laboratory TypePhysician Office
Certificate Effective DateMarch 23, 2026
Certificate Expiration DateMarch 22, 2028
Laboratory DirectorPeggy A. Fuller
Laboratory Phone(704) 370-2700
Laboratory LocationEsthetics-Center For Dermatology353 Clement Ave, Charlotte, NC 28204
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

PEGGY A FULLER MD
Specialist
353 CLEMENT AVE
CHARLOTTE, NC 28204
Mecklenburg County (704) 370-2700

Frequently Asked Questions

What is ESTHETICS CENTER FOR DERMATOLOGY PA's NPI number?

The NPI number assigned to this healthcare provider is 1891879615, enumerated as an "organization" on October 25, 2006.

Where is the provider located?

The provider is located at 353 CLEMENT AVE CHARLOTTE, NC 28204 and the phone number is (704) 370-2700.

What is the provider's specialty?

Specialist with taxonomy code 174400000X.