Active NPI
Stephen Douglas Davis, D.D.S.
- Dentist
- Colorado Springs, CO
National Provider Identifier
1982916490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10723
- Practice address
- 3605 Star Ranch Rd
Colorado Springs, CO 80906-5980 - Phone
- (719) 576-3276
- NPI assigned
- Jul 13, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9451 | OR | |
| Dentist | 122300000X | 10723 | CO | Primary |
Addresses
Primary practice location
3605 Star Ranch Rd
Colorado Springs, CO 80906-5980
Mailing address
3605 Star Ranch Rd Ste a
Colorado Springs, CO 80906-5980
Phone (719) 576-3276
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10723 | CO | MD | Dentist |
| D9451 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cheyenne Mountain Dental Group | Past | Accepting new patients | |
| Mid-Valley Dental Associates, LLC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Colorado Springs, CO
- NPI 1437171477
-
- General Practice Dentistry
- Albany, OR
- NPI 1700029709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1982916490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 STAR RANCH RD STE A",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809065980",
"telephone_number": "719-576-3276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 STAR RANCH RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809065980",
"telephone_number": "719-576-3276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "STEPHEN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-13",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D9451",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "10723",
"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 Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.