Colorado Springs Dental and Orthodontics PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COLORADO SPRINGS DENTAL AND ORTHODONTICS PLLC

Practice address

5150 N Academy Blvd
Colorado Springs, CO 80918-4002

Phone

(817) 529-8151

Fax

(817) 928-1681

NPI assigned

May 27, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Yahya Mansour, DDS

Title

Owner

Phone

(817) 529-8151

Specialties & licenses 1

Addresses

Other names 1

• Rodeo Dental and Orthodontics Doing business as

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1861068223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 15TH ST STE 520",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761026566",
            "telephone_number": "817-529-8151",
            "fax_number": "817-928-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184002",
            "telephone_number": "817-529-8151",
            "fax_number": "817-928-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS DENTAL AND ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "YAHYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-529-8151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rodeo Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.