DR. RYAN MICHAEL JACK (NPI# 1538130752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538130752 |
| Entity Type | Individual |
| Full Name | DR. RYAN MICHAEL JACK |
| Credential | D.D.S., M.S. |
| Practice Address |
8580 Scarborough Dr #200 Colorado Springs CO 80920-7583 |
| Practice Telephone | 7192826600 |
| Mailing Telephone | 7192826600 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2010-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
10046 | CO | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
DN18177 | FL | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
D-3585 | ID | Dental Providers |
| Street Address |
8580 SCARBOROUGH DR #200 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-7583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710983655 | Melinda Ann Richey | Physician Assistant | 8580 Scarborough Dr, Suite 225, Colorado Springs, CO 80920-7583 | 2005-06-24 |
| 1598111999 | Brandon Michael Basehore | Dermatology | 8580 Scarborough Dr, Colorado Springs, CO 80920-7583 | 2016-05-04 |
| 1538581301 | Briklin Nielsen | Dentist | 8580 Scarborough Dr, Suite 220, Colorado Springs, CO 80920-7583 | 2014-01-14 |
| 1780933077 | Lisa Kenner | Specialist/Technologist, Other | 8580 Scarborough Dr, Suite 125, Colorado Springs, CO 80920-7583 | 2012-09-03 |
| 1548592363 | Rational Dermatology, PC | Dermatology | 8580 Scarborough Dr, Suite 225, Colorado Springs, CO 80920-7586 | 2010-02-03 |
| 1528206976 | Robert Corr, PC | Clinic/Center | 8580 Scarborough Dr, Suite 201, Colorado Springs, CO 80920-7583 | 2009-01-22 |
| 1144427899 | James Lee Md PC | Ophthalmology | 8580 Scarborough Dr, Suite 125, Colorado Springs, CO 80920-7502 | 2007-06-27 |
| 1982702239 | Samantha M Jordan | Dermatology | 8580 Scarborough Dr, Suite 225, Colorado Springs, CO 80920-7583 | 2006-09-20 |
| 1396772372 | James H Lee | Ophthalmology | 8580 Scarborough Dr, Suite 125, Colorado Springs, CO 80920-7502 | 2006-06-27 |
| 1356334965 | Reagan B Anderson | Dermatology | 8580 Scarborough Dr, Suite 225, Colorado Springs, CO 80920-7586 | 2005-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329047 | Front Range Endodontics, Pllc | Dentist | 2116 Hollow Brook Dr Ste 200, Colorado Springs, CO 80918-1790 | 2020-09-06 |
| 1447803382 | Jj Elevation, Pllc | Dentist | 10012 Coyote Song Ter, Colorado Springs, CO 80924-4504 | 2019-07-19 |
| 1881126159 | Zane Lambert | Dentist | 3216 Springridge Dr, Colorado Springs, CO 80906-3745 | 2017-03-28 |
| 1558806679 | Soco Endo | Dentist | 830 Tenderfoot Hill Rd Ste 150, Colorado Springs, CO 80906-7377 | 2016-12-28 |
| 1871035212 | Transtrum Endodontics Pllc | Dentist | 9475 Briar Village Pt.-suite 300, Colorado Springs, CO 80920 | 2016-11-16 |
| 1649694480 | Sakib Vahora | Dentist | 3715 Bloomington St Unit 160, Colorado Springs, CO 80922-3207 | 2014-02-14 |
| 1932354255 | Robert Peter Corr | Dentist | 4218 Apache Plume Dr, Colorado Springs, CO 80920-7665 | 2008-12-01 |
| 1376717322 | David M. Mccarty | Dentist | 13710 Struthers Rd, Suite 200, Colorado Springs, CO 80921-2467 | 2008-04-21 |
| 1427233212 | William C Roth Dds PC | Dentist | 2116 Hollow Brook Drive #200, Colorado Springs, CO 80918 | 2007-12-31 |
| 1922101005 | Deborah C Knaup | Dentist | 5050 N Academy Blvd, Colorado Springs, CO 80918-4124 | 2006-09-06 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.