Individual provider Active NPI

Edward J McCulloch, DDS

  • Public Health Dentistry
  • Colorado Springs, CO
National Provider Identifier
1427058445
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
104717 Issued in CO
Practice address
3585 Van Teylingen Dr
Ste F
Colorado Springs, CO 80917-4875
Phone
(719) 597-7111
Fax
(719) 572-0177
NPI assigned
Aug 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 104717 CO Primary

Addresses

Primary practice location

3585 Van Teylingen Dr
Ste F
Colorado Springs, CO 80917-4875

Mailing address

3585 Van Teylingen Dr
Ste F
Colorado Springs, CO 80917-4875
Phone (719) 597-7111

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

LicenseStateTypeSpecialty
104717COMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1427058445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR",
            "address_2": "STE F",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174875",
            "telephone_number": "719-597-7111",
            "fax_number": "719-572-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR",
            "address_2": "STE F",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174875",
            "telephone_number": "719-597-7111",
            "fax_number": "719-572-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CO",
            "license": "104717",
            "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 Jul 13, 2026; 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.