NPIMap

Organization Active NPI

Elite Dental Associates, PLLC

  • Dental Clinic/Center
  • Dallas, TX
National Provider Identifier
1639542855
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
26315 Issued in TX
Legal business name
ELITE DENTAL ASSOCIATES, PLLC
Practice address
5815 Live Oak St
Suite 103
Dallas, TX 75214-7310
Phone
(814) 571-3806
NPI assigned
Nov 10, 2015
Last updated
Nov 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Dr. Lawrence Wong, DMDNPI 1629396247
Title
President
Phone
(814) 571-3806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 26315 TX Primary

Addresses

Primary practice location

5815 Live Oak St
Suite 103
Dallas, TX 75214-7310

Mailing address

7417 Wellcrest Dr
Dallas, TX 75230-4235

National Provider Directory

National Provider Directory

Locations

5815 Live Oak St
Ste 103
Dallas, TX 75214
Phone (814) 571-3806

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": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1639542855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 WELLCREST DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752304235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 LIVE OAK ST",
            "address_2": "SUITE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752147310",
            "telephone_number": "814-571-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-571-3806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "26315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.