Dr. Anthony Russell Immediata
DMD, PA | Oral and Maxillofacial Surgeon
7101 Creedmoor Rd, Suite 109, Raleigh
North Carolina, 27613-1682
919-846-5500 Maps & DirectionsDr. Anthony Russell Immediata is a Raleigh, North Carolina based Oral and Maxillofacial Surgeon who is specialized in
Oral and Maxillofacial Surgery. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Anthony Russell Immediata is
5022 for Oral and Maxillofacial Surgery in North Carolina. His current practice location is
7101 Creedmoor Rd, Suite 109, Raleigh. Patients can reach him at
919-846-5500.
Dr. Anthony Russell Immediata deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Profile:
Dr. Anthony Russell Immediata speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Anthony Russell Immediata |
| Specialization: | Oral and Maxillofacial Surgeon |
| Gender: | Male |
| Credentials: | DMD, PA |
| Accepts Medicare Assignment: | No |
| Practice Address: | 7101 Creedmoor Rd, Suite 109, Raleigh,
North Carolina, 27613-1682 |
| Phone: | 919-846-5500 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1609809292 |
| NPI Enumeration Date: | 08 Jul, 2006 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Anthony Russell Immediata are as mentioned below.
| License Number | Specialization | State | Status | |
| 5022 | Oral and Maxillofacial Surgery | North Carolina | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Anthony Russell Immediata such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 8994426 | Medicaid | North Carolina | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 7101 Creedmoor Rd, Suite 109
Raleigh, North Carolina |
| Zip: | 27613-1682 |
| Phone Number: | 919-846-5500 |
Patients can reach Dr. Anthony Russell Immediata at
7101 Creedmoor Rd, Suite 109, Raleigh, North Carolina or can
call to book an appointment on 919-846-5500.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.