Healthcare Provider Details

I. General information

NPI: 1346104007
Provider Name (Legal Business Name): DRS GROODY PATERRA AND REIMELS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13605 REESE BLVD W
HUNTERSVILLE NC
28078-6250
US

IV. Provider business mailing address

13605 REESE BLVD W
HUNTERSVILLE NC
28078-6250
US

V. Phone/Fax

Practice location:
  • Phone: 704-948-1111
  • Fax: 704-823-6367
Mailing address:
  • Phone: 704-948-1111
  • Fax: 704-823-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AMANDA NOELLE GROESCHEL
Title or Position: DIRECTOR
Credential:
Phone: 704-978-9800