Healthcare Provider Details

I. General information

NPI: 1962326918
Provider Name (Legal Business Name): ELEVATE DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 BELGROVE DR
KEARNY NJ
07032-1657
US

IV. Provider business mailing address

73 TRAPHAGEN RD APT B
WAYNE NJ
07470-7995
US

V. Phone/Fax

Practice location:
  • Phone: 973-981-6848
  • 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: GEORGE DAHDOUH
Title or Position: OWNER
Credential: DDS
Phone: 963-981-6848