Healthcare Provider Details

I. General information

NPI: 1538518840
Provider Name (Legal Business Name): STEVEN DEREK ROBERTSON D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 WICKER ST STE A
SANFORD NC
27330-4168
US

IV. Provider business mailing address

709 WICKER ST STE A
SANFORD NC
27330-4168
US

V. Phone/Fax

Practice location:
  • Phone: 704-523-0551
  • Fax:
Mailing address:
  • Phone: 919-842-5300
  • Fax: 919-709-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number10934
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: