Individual provider Active NPI

Eyitemi Elete

  • Dentist
  • Waco, TX
National Provider Identifier
1023799558
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41409 Issued in TX
Practice address
2320 W Loop 340 Ste 200B
Waco, TX 76711-2454
Phone
(254) 230-9597
NPI assigned
Jul 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.035381 IL
Dentist 122300000X DN123199 GA
Dentist 122300000X 41409 TX Primary

Addresses

Primary practice location

2320 W Loop 340 Ste 200B
Waco, TX 76711-2454

Mailing address

2320 W Loop 340 Ste 200B
Waco, TX 76711-2454
Phone (213) 905-5600

Other practice location 1

3456 Wrightsboro Rd
Augusta, GA 30909-2678
Phone (706) 251-7917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN123199GAMDDentist
019.035381ILMDDentist
41409TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dan Alineum Dental-Waco PLLC CurrentSince Jun 15, 2025 Accepting new patients

Locations

2320 W Loop 340
Ste 200B
Waco, TX 76711
Phone (254) 230-9597

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1023799558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 W LOOP 340 STE 200B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112454",
            "telephone_number": "213-905-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 W LOOP 340 STE 200B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112454",
            "telephone_number": "254-230-9597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3456 Wrightsboro Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309092678",
            "country_code": "US",
            "telephone_number": "706-251-7917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELETE",
        "first_name": "EYITEMI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.035381",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123199",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "41409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.