ELITE LEGACY COLLECTIVE LLC NPI 1548119092

NPI Information

  • NPI: 1548119092
  • Provider Name: ELITE LEGACY COLLECTIVE, LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 9712 BELAIR RD STE 304
    NOTTINGHAM, MD
    ZIP 21236
  • Phone: (410) 538-2422

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NPI Details

ELITE LEGACY COLLECTIVE, LLC is a dental clinic center in Nottingham, MD. ELITE LEGACY COLLECTIVE, LLC NPI is 1548119092. The provider is registered as an organization entity type.

The provider's business location address is:

9712 BELAIR RD STE 304
NOTTINGHAM, MD
ZIP 21236-113
Phone: (410) 538-2422
Fax: (410) 538-2944

The provider's authorized official is Dana Truesdale .
The authorized official title is Owner and has the following contact phone number (804) 614-8812.

The enumeration date for this NPI number is 1/27/2026 and was last updated on 1/27/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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