NPIMap

Individual provider Active NPI

John S Lydiatt, D.D.S.

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1922121383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7736 Issued in CO
Practice address
6665 Delmonico Dr
Suite C
Colorado Springs, CO 80919-6801
Phone
(719) 599-5700
Fax
(719) 260-5685
NPI assigned
Apr 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 7736 CO Primary

Addresses

Primary practice location

6665 Delmonico Dr
Suite C
Colorado Springs, CO 80919-6801

Mailing address

6665 Delmonico Dr
Suite C
Colorado Springs, CO 80919-6801
Phone (719) 599-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7736COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Maxillofacial and Oral Surgery, PLLC CurrentSince May 27, 2024 Accepting new patients
Associates in Maxillofacial and Oral Surgery, PLLC CurrentSince May 27, 2024 Accepting new patients
Associates in Maxillofacial and Oral Surgery, PLLC Past Accepting new patients
Lydiatt and Duru Family Dentistry General Practice Past Accepting new patients
Springs Dentistry, PLLC General Practice PastSince Nov 1, 2019 Accepting new patients
Associates in Maxillofacial and Oral Surgery, PLLC Past Accepting new patients
Associates in Maxillofacial and Oral Surgery, PLLC Past Accepting new patients
Associates in Maxillofacial and Oral Surgery, PLLC Past Accepting new patients

Locations

1755 Telstar Dr
Ste 210
Colorado Springs, CO 80920
Phone 71930059331011

320 E Fontanero St
Ste 200
Colorado Springs, CO 80907
Phone (718) 471-0080

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922121383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6665 DELMONICO DR",
            "address_2": "SUITE C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809196801",
            "telephone_number": "719-599-5700",
            "fax_number": "719-260-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6665 DELMONICO DR",
            "address_2": "SUITE C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809196801",
            "telephone_number": "719-599-5700",
            "fax_number": "719-260-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDIATT",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.