NPIMap

Organization Active NPI

Soco Endo

  • Endodontics
  • Colorado Springs, CO
National Provider Identifier
1558806679
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
SOCO ENDO
Practice address
1275 Lake Plaza Drive
Suite #200
Colorado Springs, CO 80906
Phone
(719) 301-1119
Fax
(719) 301-1131
NPI assigned
Dec 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Dr. Tyler J. Boss, DDSNPI 1811251598
Title
Endodontist/Owner
Phone
(719) 301-1131

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1275 Lake Plaza Drive
Suite #200
Colorado Springs, CO 80906

Mailing address

1275 Lake Plaza Drive
Suite #200
Colorado Springs, CO 80906
Phone (719) 301-1119

Other names 1

  • Southern Colorado Endodontics Other name

National Provider Directory

National Provider Directory

Locations

1275 Lake Plaza Dr
Ste 200
Colorado Springs, CO 80906
Phone (719) 301-1119

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1558806679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 LAKE PLAZA DRIVE",
            "address_2": "SUITE #200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-301-1119",
            "fax_number": "719-301-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 LAKE PLAZA DRIVE",
            "address_2": "SUITE #200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-301-1119",
            "fax_number": "719-301-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCO ENDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "BOSS",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ENDODONTIST/OWNER",
        "authorized_official_telephone_number": "719-301-1131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Colorado Endodontics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Southern Colorado Endodontics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 22, 2023; 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.