ELITE DENTAL GROUP PA NPI 1972711794

NPI Information

  • NPI: 1972711794
  • Provider Name: ELITE DENTAL GROUP, PA
  • Classification: Dentist - 1223P0700X
  • Specialization: Prosthodontics
  • Entity Type: Organization
  • Address: 1501 HANDLEY DR
    FORT WORTH, TX
    ZIP 76112
  • Phone: (817) 451-4141

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NPI Details

ELITE DENTAL GROUP, PA is a prosthodontics dentist in Fort Worth, TX. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. ELITE DENTAL GROUP, PA NPI is 1972711794. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1501 HANDLEY DR
FORT WORTH, TX
ZIP 76112-328
Phone: (817) 451-4141
Fax: (817) 457-4142

The provider's authorized official is Jennie Ha Luong .
The authorized official title is Regional Manager and has the following contact phone number (817) 457-4141.

The enumeration date for this NPI number is 5/18/2007 and was last updated on 8/17/2007.

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
11223P0700XDentistProsthodontics18994TEXASYes

What is NPI?

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This page was last updated on: 3/30/2025

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