Individual provider Active NPI

Daniel Ryan Skaggs

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1730675588
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN00203667 Issued in CO
Practice address
3755 Briargate Blvd Ste 200
Colorado Springs, CO 80920-4194
Phone
(719) 434-5800
NPI assigned
Jul 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DEN00203667 CO Primary

Addresses

Primary practice location

3755 Briargate Blvd Ste 200
Colorado Springs, CO 80920-4194

Mailing address

3755 Briargate Blvd Ste 200
Colorado Springs, CO 80920-4194
Phone (719) 434-5800

Other practice location 1

1628 W 3rd Ave
Williamson, WV 25661-3007
Phone (304) 236-2366

Other practice location 2

4451 Venetucci Blvd Unit 160
Colorado Springs, CO 80906-4056
Phone (719) 392-5354

Other practice location 3

111 Heritage Sq
Sellersburg, IN 47172-1863
Phone (812) 248-4880

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
DEN00203667COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Skaggs DMD PLLC CurrentSince Jun 23, 2024 Accepting new patients
TDS in Three LLC CurrentSince Nov 1, 2020 Accepting new patients
Rangewood Dental Dentist PastSince Jun 23, 2024 Accepting new patients
Jason R Long DDS, PLLC Single Specialty PastSince Aug 25, 2025 Accepting new patients

Locations

3755 Briargate Blvd
Ste 200
Colorado Springs, CO 80920
Phone (719) 434-5800

111 Heritage Sq
Sellersburg, IN 47172
Phone (812) 248-4880

Organizations & group practices 4

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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1730675588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 BRIARGATE BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204194",
            "telephone_number": "719-434-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 BRIARGATE BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204194",
            "telephone_number": "719-434-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1628 W 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Williamson",
            "state": "WV",
            "postal_code": "256613007",
            "country_code": "US",
            "telephone_number": "304-236-2366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4451 Venetucci Blvd Unit 160",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809064056",
            "country_code": "US",
            "telephone_number": "719-392-5354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Heritage Sq",
            "address_purpose": "LOCATION",
            "city": "Sellersburg",
            "state": "IN",
            "postal_code": "471721863",
            "country_code": "US",
            "telephone_number": "812-248-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKAGGS",
        "first_name": "DANIEL",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN00203667",
            "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 Jun 19, 2024; 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.