OrganizationActive
East Texas Dental Group, LLC
NPI 1750743167 · Dentist · Tyler, TX
East Texas Dental Group, LLC is a Dentist organization in Tyler, TX (NPI 1750743167).
Provider details
- NPI number
- 1750743167
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Young Shim, Owner(903) 509-0505
- License
- 31033 (TX)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
212 Old Grande Blvd
B224
Tyler, TX 75703-4226
Phone: (903) 509-0505
Fax: (903) 509-0506
Street-level locationGet directions
Mailing address
212 Old Grande Blvd
Tyler, TX 75703-4226
Registry dates
- Enumerated
- 2016-03-24
- Last updated
- 2016-03-24
Frequently asked questions
- What is East Texas Dental Group, LLC's NPI number?
- East Texas Dental Group, LLC's National Provider Identifier (NPI) is 1750743167, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is East Texas Dental Group, LLC?
- East Texas Dental Group, LLC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is East Texas Dental Group, LLC located?
- East Texas Dental Group, LLC's practice location on file with NPPES is 212 Old Grande Blvd, Tyler, TX 75703-4226.
- What is East Texas Dental Group, LLC's phone number?
- The practice phone number listed in the NPPES registry for East Texas Dental Group, LLC is (903) 509-0505.
- Who is the authorized official for East Texas Dental Group, LLC?
- The authorized official listed on East Texas Dental Group, LLC's NPPES record is Young Shim, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is East Texas Dental Group, LLC's NPI active?
- Yes — East Texas Dental Group, LLC's NPI (1750743167) is active in the NPPES registry as of the last update on 2016-03-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.