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General NPI Number Information
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NPI Number | 1184536245
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Entity Type | Organization
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Legal Business Name | ELITE DENTAL GROUP VA, PLLC
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 121 PARK HILL DR STE A
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3357
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Country | US
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Telephone | 540-373-1660
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Fax | 540-373-6830
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Provider Business Mailing Address
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Address Line | 121 PARK HILL DR STE A
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3357
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Country | US
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Telephone | 540-373-1660
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Fax | 540-373-6830
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Authorized Official
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Title or Position | OWNER
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Name | DR. KAVISH A GURJAR
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Credential | DDS
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Telephone | 540-373-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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