Healthcare Provider Details

I. General information

NPI: 1578403978
Provider Name (Legal Business Name): HD DENTAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11085 E MISSISSIPPI AVE
AURORA CO
80012-3104
US

IV. Provider business mailing address

11085 E MISSISSIPPI AVE
AURORA CO
80012-3104
US

V. Phone/Fax

Practice location:
  • Phone: 303-696-6979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DAT DAVID LE
Title or Position: MANAGER/ OWNER
Credential: DDS
Phone: 954-614-0768