Provider Demographics
NPI:1255006532
Name:TIPPIT DENTAL GROUP ELGIN
Entity Type:Organization
Organization Name:TIPPIT DENTAL GROUP ELGIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-677-9983
Mailing Address - Street 1:9099 KATY FWY STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1632
Mailing Address - Country:US
Mailing Address - Phone:713-465-1860
Mailing Address - Fax:
Practice Address - Street 1:1309 N AVENUE C
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-1528
Practice Address - Country:US
Practice Address - Phone:512-281-4260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental