Elite Dental – Dentist in Arlington, VA

Key facts

NPI: 1669907036
Entity type: Organization (NPI type 2)
Primary specialty: Dentist 122300000X
Legal business name: ELITE DENTAL
Practice address: 1025 N Fillmore St Ste C
Arlington, VA 22201-6700
Phone: (703) 243-4500
NPI assigned: Apr 24, 2017
Organization subpart: No

Authorized official

Name: Stephanie Gomez
Title: Credentialing Coordinator
Phone: (305) 274-2499

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Scott Branin Dudley, DMD, MSED, FAGD Dentist · Arlington, VA · NPI 1336134048

NPD (past) DENTIST
Alyssa Hartman, DDS Dentist · Arlington, VA · NPI 1679969653

NPD (past) DENTIST

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist Group: 193400000X SINGLE SPECIALTY GROUP	122300000X			Yes

Addresses

Primary practice location

1025 N Fillmore St Ste C
Arlington, VA 22201-6700

Mailing address

1025 N Fillmore St Ste C
Arlington, VA 22201-6700
Phone (703) 243-4500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 24, 2017.

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1669907036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N FILLMORE ST STE C",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222016700",
            "telephone_number": "703-243-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N FILLMORE ST STE C",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222016700",
            "telephone_number": "703-243-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-24",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

All providers in Arlington, VA · Dentist in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.