MEDICARE: DR. DARREN RICHARD CROSS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	9386	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497829311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN RICHARD CROSS DDS

Provider Business Mailing Address
First Line	:	1005 BRANDON CT
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-9380
Country	:	US
Telephone Number	:	336-860-4119
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 FREEMAN PARK DR # C100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-3237
Country	:	US
Telephone Number	:	980-580-4271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	10/11/2023

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