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ELITE DENTAL GROUP CANON CITY
NPI 1518747765
Clinic/Center - Dental in Canon City, CO

Active since October 04, 2023
1215 N 15TH ST, CANON CITY, CO 81212(719) 275-5933 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 15, 2023, Oct 4, 2023 (2 updates tracked since 2023).

About Elite Dental Group Canon City NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELITE DENTAL GROUP CANON CITY (NPI 1518747765) is a healthcare organization registered as a dental in Canon City, Colorado and active in the NPI registry since October 2023. The organization lists Kyu Hyuk Jung, President/dentist, as its authorized official.

NPPES Registry Identity

NPI1518747765
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameELITE DENTAL GROUP CANON CITY INC
Location Address1215 N 15TH STCanon City, CO 81212-4620
Mailing Address1215 N 15th StCanon City, CO 81212-4620
Phone(719) 275-5933
Organization SubpartNo
Authorized OfficialKyu Hyuk JungPresident/dentist · (719) 275-5933
Enumeration DateOctober 4, 2023
Last NPPES UpdateNovember 15, 20232 updates tracked since enumeration
NPPES CertifiedNovember 15, 2023
✔ NPI 1518747765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1215 N 15TH ST, Canon City, CO 81212
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Other Names 1

Doing Business AsElite Dental Group Canon City

Other Identifiers 1

Medicaid1396261251CO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEAN E SANDOVAL D.D.S.
Dentist (General Practice)
1215 N 15TH ST
CANON CITY, CO 81212
Fremont County (719) 275-5933
MS. ROBERTA JO BROMAN R.D.H.
Dental Hygienist
1215 N 15TH ST
CANON CITY, CO 81212
Fremont County (719) 269-7194

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elite Dental Group Canon City Inc's NPI number?

The NPI number for Elite Dental Group Canon City Inc is 1518747765. It was assigned to this organization in the NPPES registry on October 4, 2023. The provider is doing business as Elite Dental Group Canon City.

Where is Elite Dental Group Canon City Inc located?

Elite Dental Group Canon City Inc is located at 1215 N 15th St, Canon City, CO 81212. The listed phone number is (719) 275-5933.

What is Elite Dental Group Canon City Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

What insurance does Elite Dental Group Canon City Inc accept?

Health plans from UnitedHealthcare list Elite Dental Group Canon City Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Elite Dental Group Canon City Inc was last updated on November 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.