Healthcare Provider Details

I. General information

NPI: 1609763267
Provider Name (Legal Business Name): ELEVATE DENTAL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 N US HIGHWAY 1 STE 6
TEQUESTA FL
33469-3241
US

IV. Provider business mailing address

1620 N US HIGHWAY 1 STE 6
TEQUESTA FL
33469-3241
US

V. Phone/Fax

Practice location:
  • Phone: 561-744-0677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA TSENG
Title or Position: OWNER
Credential:
Phone: 772-913-0127