Individual provider Active NPI

Ryan M Teagardin, DMD

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1659943371
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00205916 Issued in CO
Practice address
6376 San Mateo Dr
Colorado Springs, CO 80911-4015
Phone
(815) 262-4840
NPI assigned
Jul 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12341536-9921 UT
Dentist 122300000X DEN.00205916 CO Primary

Addresses

Primary practice location

6376 San Mateo Dr
Colorado Springs, CO 80911-4015

Mailing address

1667 Cochrane Cir BLDG 7495
Fort Carson, CO 80913-4603
Phone (719) 526-5537

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
DEN.00205916COMDDentist
12341536-9921UTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1659943371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 COCHRANE CIR BLDG 7495",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-526-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6376 SAN MATEO DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809114015",
            "telephone_number": "815-262-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGARDIN",
        "first_name": "RYAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12341536-9921",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205916",
            "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 Apr 14, 2025; 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.