Healthcare Provider Details

I. General information

NPI: 1386048726
Provider Name (Legal Business Name): ELITE DENTISTRY II, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 OLD FREDERICKSBURG RD STE D102
AUSTIN TX
78749-1210
US

IV. Provider business mailing address

5901 OLD FREDERICKSBURG RD STE D102
AUSTIN TX
78749-1210
US

V. Phone/Fax

Practice location:
  • Phone: 512-892-9900
  • Fax:
Mailing address:
  • Phone: 512-892-9900
  • 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: DR. DARIAN KAAR
Title or Position: DENTIST/PROSTHODONIST
Credential: DDS, MSD, FACP
Phone: 512-892-9900