SUNRISE DERMATOLOGY – NPI #1477708642
Dermatology

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

SUNRISE DERMATOLOGY is a dermatologist located in VESTAVIA HILLS, AL. NPPES has assigned the NPI number 1477708642 to SUNRISE DERMATOLOGY on December 01, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SUNRISE DERMATOLOGY” is a dba name, the actual legal business name for this organization is AQUA DERMATOLOGY OF ALABAMA PC. The NPI data also shows multiple names associated with this provider such as SUNRISE DERMATOLOGY and 2 other listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207ND0101X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in MOHS-Micrographic Surgery

The NPI profile was last updated on Jun 25, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SUNRISE DERMATOLOGY below.

NPI Profile for
AQUA DERMATOLOGY OF ALABAMA PC

NPI Number
1477708642
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AQUA DERMATOLOGY OF ALABAMA PC
Doing Business As (dba): SUNRISE DERMATOLOGY
Other name(s)
All associated names:
Doing Business As (dba)
SUNRISE DERMATOLOGY
Doing Business As (dba)
Surgical Dermatology Group
Doing Business As (dba)
True Dermatology
Primary location
1940 STONEGATE DR STE 130
VESTAVIA HILLS, AL 35242
Phone: (205) 977-9876 Fax: (205) 977-9976
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
KAREN LAKE
ADMINISTRATION
Phone: (205) 977-9786
Updated
Certification Date
Jun 25, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207ND0101X
- Dermatology / MOHS-Micrographic Surgery (Primary)
AL 20579
207NS0135X
- Dermatology / Procedural Dermatology
AL 20579
207N00000X
- Dermatology
AL 20579

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.