Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

East Texas Dental Group, LLC

Organization Dentist · NPI 1750743167

East Texas Dental Group, LLC is a Dentist in Tyler, Texas. Licensed in Texas. Registered with an NPI since 2016.

Licensed in
TX
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

212 Old Grande Blvd B224
Tyler, TX 75703-4226
Phone: (903) 509-0505
Fax: (903) 509-0506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 31033 (TX)

Record details

NPI number1750743167
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Young Shim — Owner · (903) 509-0505
NPI enumeratedMarch 24, 2016
Last updated in NPPESMarch 24, 2016
Mailing address212 Old Grande Blvd, Suite B224, Tyler, TX 75703-4226

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