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NPI Code Detail

MEDICARE: ELITE DENTAL GROUP WESTMINSTER INC

MEDICARE: ELITE DENTAL GROUP WESTMINSTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1598481871
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE DENTAL GROUP WESTMINSTER INC
Provider Business Mailing Address
First Line : 5068 W 92ND AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80031-6302
Country : US
Telephone Number : 303-426-0023
Fax Number :
Provider Business Practice Location Address
First Line : 5068 W 92ND AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80031-6302
Country : US
Telephone Number : 303-426-0023
Fax Number :
Authorized Official
Title or Position : ADMINISTRATIVE DIRECTOR
Name : MS. BO NAM
Credential :
Telephone Number : 720-278-8492
Provider Enumeration Date : 10/18/2022
Last Update Date : 12/19/2025

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Directions to “ELITE DENTAL GROUP WESTMINSTER INC ” Practice Location

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