Elite Dental Group Lakewood Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ELITE DENTAL GROUP LAKEWOOD INC

Practice address

1200 S Wadsworth Blvd Ste 200
Lakewood, CO 80232-5434

Phone

(303) 733-7533

NPI assigned

May 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Kyu Hyuk Jung, DDS

Title

President/Dentist

Phone

(303) 733-7533

Specialties & licenses 1

Addresses

Other names 1

• Elite Dental Lakewood Doing business as

Electronic endpoints 2

Locations

Interoperability endpoints

• Direct secure messaging: lakewood@elitedentalco.com

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1902489016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S WADSWORTH BLVD STE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325434",
            "telephone_number": "303-733-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S WADSWORTH BLVD STE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325434",
            "telephone_number": "303-733-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL GROUP LAKEWOOD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "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": "HYUK",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "303-733-7533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lakewood@elitedentalco.com",
            "affiliation": "N",
            "endpointDescription": "Lakewood office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 S Wadsworth Blvd Ste 200",
            "city": "Lakewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802325434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lakewood@elitedentalco.com",
            "affiliation": "N",
            "endpointDescription": "lakewood@elitedentalco.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 S Wadsworth Blvd Ste 200",
            "city": "Lakewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802325434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Elite Dental Lakewood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elite Dental Lakewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Dental Clinic/Center in Colorado

• 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.