ELITE LEGACY COLLECTIVE, LLC – NPI #1548119092
Clinic/Center

ELITE LEGACY COLLECTIVE, LLC is an AHC clinic located in NOTTINGHAM, MD. NPPES has assigned the NPI number 1548119092 to ELITE LEGACY COLLECTIVE, LLC on January 27, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ELITE LEGACY COLLECTIVE, LLC below.

NPI Profile for
ELITE LEGACY COLLECTIVE, LLC

NPI Number
1548119092
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ELITE LEGACY COLLECTIVE, LLC
Primary location
9712 BELAIR RD STE 304
NOTTINGHAM, MD 21236-1113
Phone: (410) 538-2422 Fax: (410) 538-2944
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DANA TRUESDALE
OWNER
Phone: (804) 614-8812
Updated
Certification Date
Jan 27, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.