Healthcare Provider Details

I. General information

NPI: 1356256002
Provider Name (Legal Business Name): RODRIGO SARMENTO, DMD, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12312 COPPER WAY STE 100
CHARLOTTE NC
28277-4856
US

IV. Provider business mailing address

12312 COPPER WAY STE 100
CHARLOTTE NC
28277-4856
US

V. Phone/Fax

Practice location:
  • Phone: 704-541-6070
  • Fax:
Mailing address:
  • Phone: 704-541-6070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: RODRIGO SARMENTO
Title or Position: SOLE MEMBER
Credential: DMD, MD
Phone: 727-656-4827