NPIMap

Organization Active NPI

Elite Dental Group Aurora Inc

Doing business as Elite Dental Group Aurora

  • Dental Clinic/Center
  • Aurora, CO
National Provider Identifier
1366002131
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ELITE DENTAL GROUP AURORA INC
Doing business as
Elite Dental Group Aurora
Practice address
10700 E Bethany Dr Ste 210
Aurora, CO 80014-2680
Phone
(303) 745-8828
Fax
(720) 748-8867
NPI assigned
Jun 14, 2019
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Kyu H Jung, DDSNPI 1396261251
Title
Owner
Phone
(303) 745-8828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

10700 E Bethany Dr Ste 210
Aurora, CO 80014-2680

Mailing address

10700 E Bethany Dr Ste 210
Aurora, CO 80014-2680
Phone (303) 745-8828

Other identifiers 1

IdentifierTypeStateIssuer
1396261251MedicaidCO

Other names 2

  • Elite Dental Group Aurora Doing business as
  • Elite Dental Group INC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1366002131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 E BETHANY DR STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142680",
            "telephone_number": "303-745-8828",
            "fax_number": "720-748-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 E BETHANY DR STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142680",
            "telephone_number": "303-745-8828",
            "fax_number": "720-748-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL GROUP AURORA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-14",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "KYU",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-745-8828",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396261251",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Dental Group Aurora",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elite Dental group Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elite Dental Group INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.