Individual provider Active NPI

William Todd Rogers, DDS

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1477561454
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
C06876 Issued in CO
Practice address
5575 Tech Center Drive
Suite 103
Colorado Springs, CO 80919
Phone
(719) 528-6450
Fax
(719) 528-5834
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X C06876 CO Primary

Addresses

Primary practice location

5575 Tech Center Drive
Suite 103
Colorado Springs, CO 80919

Mailing address

5575 Tech Center Drive
Suite 103
Colorado Springs, CO 80919
Phone (719) 528-6450

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
I20160225000561 CO Order and Referring Only - DentistPractitioner - Dentist 0941505176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C06876COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477561454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 TECH CENTER DRIVE",
            "address_2": "SUITE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80919",
            "telephone_number": "719-528-6450",
            "fax_number": "719-528-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 TECH CENTER DRIVE",
            "address_2": "SUITE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80919",
            "telephone_number": "719-528-6450",
            "fax_number": "719-528-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "WILLIAM",
        "middle_name": "TODD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "C06876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.