NPIMap

Organization Active NPI

Crossroads Family Dentistry

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1396137907
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10399 Issued in CO
Legal business name
CROSSROADS FAMILY DENTISTRY
Practice address
1079 Space Center Dr
Suite 100
Colorado Springs, CO 80915-3612
Phone
(719) 596-3481
Fax
(719) 596-9114
NPI assigned
Feb 19, 2015
Last updated
Feb 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Dr. Ryan Tyng, D.M.DNPI 1780848176
Title
Dentist
Phone
(719) 596-3481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 10399 CO Primary

Addresses

Primary practice location

1079 Space Center Dr
Suite 100
Colorado Springs, CO 80915-3612

Mailing address

1079 Space Center Dr
Suite 100
Colorado Springs, CO 80915-3612
Phone (719) 596-3481

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1079 Space Center Dr
Unit 100
Colorado Springs, CO 80915
Phone (719) 574-2211

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1396137907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 SPACE CENTER DR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809153612",
            "telephone_number": "719-596-3481",
            "fax_number": "719-596-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 SPACE CENTER DR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809153612",
            "telephone_number": "719-596-3481",
            "fax_number": "719-596-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-19",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "TYNG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "719-596-3481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10399",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.