Active NPI
Neill Curtis Slack, D.D.S.
- Dentist
- Colorado Springs, CO
National Provider Identifier
1386750081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5521
- Practice address
- 5925 Lehman Dr. #2
Colorado Springs, CO 80918 - Phone
- (719) 698-6966
- Fax
- (844) 335-8493
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5521 | CO | |
| Dentist | 122300000X | 5521 | CO | Primary |
Addresses
Primary practice location
5925 Lehman Dr. #2
Colorado Springs, CO 80918
Mailing address
5925 Lehman Dr. #2
Colorado Springs, CO 80918
Phone (719) 698-6966
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2006267211 | Other | CO | TAX ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5521 | CO | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lehman Drive PDC PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1386750081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5925 LEHMAN DR. #2",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80918",
"telephone_number": "719-698-6966",
"fax_number": "844-335-8493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5925 LEHMAN DR. #2",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80918",
"telephone_number": "719-698-6966",
"fax_number": "844-335-8493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLACK",
"first_name": "NEILL",
"middle_name": "CURTIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "5521",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "5521",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID NUMBER",
"identifier": "2006267211",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.