Individual provider Active NPI

Gregory M Solich, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1629276878
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
05146 Issued in CO
Practice address
10807 New Allegiance Dr Ste 465
Colorado Springs, CO 80921-3722
Phone
(719) 548-9393
Fax
(719) 548-9313
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 05146 CO Primary

Addresses

Primary practice location

10807 New Allegiance Dr Ste 465
Colorado Springs, CO 80921-3722

Mailing address

5426 N Academy Blvd Ste 105
Colorado Springs, CO 80918-3686
Phone (719) 548-9393

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
I20161213000787 CO Order and Referring Only - DentistPractitioner - Dentist 6305168568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05146COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptional Sleep Colorado Springs LLC CurrentSince Jan 1, 2019 Accepting new patients
My Local Colorado Dental Practice, LLC General Practice PastSince Nov 8, 2020 Accepting new patients

Locations

10807 New Allegiance Dr
Ste 465
Colorado Springs, CO 80921
Phone (719) 548-9393

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1629276878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5426 N ACADEMY BLVD STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183686",
            "telephone_number": "719-548-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10807 NEW ALLEGIANCE DR STE 465",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213722",
            "telephone_number": "719-548-9393",
            "fax_number": "719-548-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLICH",
        "first_name": "GREGORY",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "05146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.