Individual provider Active NPI

Mark Harold Wright, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1295830735
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6782 Issued in CO
Practice address
930 N Cedar St
Colorado Springs, CO 80903-2720
Phone
(719) 635-1622
Fax
(719) 635-3956
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6782 CO Primary

Addresses

Primary practice location

930 N Cedar St
Colorado Springs, CO 80903-2720

Mailing address

930 N Cedar St
Colorado Springs, CO 80903-2720
Phone (719) 624-4122

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ColoradoSprings Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151221000519 CO Order and Referring Only - DentistPractitioner - Dentist 0446551295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6782COMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1295830735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 N CEDAR ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032720",
            "telephone_number": "719-624-4122",
            "fax_number": "719-635-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N CEDAR ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032720",
            "telephone_number": "719-635-1622",
            "fax_number": "719-635-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MARK",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ColoradoSprings",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "930 N Cedar St",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809032720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.