BROADMOOR LAKE DENTAL
NPI 1801286919
Dentist in Colorado Springs, CO

Q: What is Broadmoor Lake Dental's NPI number?

The NPI number for Broadmoor Lake Dental is 1801286919. It was assigned to this organization in the NPPES registry on January 27, 2015.

Q: What is Broadmoor Lake Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since January 27, 2015

155 LAKE AVE STE 201, COLORADO SPRINGS, CO 80906(719) 375-5201(844) 656-9696 Get Directions Write a Review

NPPES record last updated: July 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2021, Jun 30, 2021 (2 updates tracked since 2021).

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About Broadmoor Lake Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROADMOOR LAKE DENTAL (NPI 1801286919) is a healthcare organization registered as a dentist in Colorado Springs, Colorado and active in the NPI registry since January 2015. The organization lists Marc Van Ness, Owner, as its authorized official.

NPPES Registry Identity

NPI1801286919

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameBROADMOOR LAKE DENTAL

Location Address155 LAKE AVE STE 201Colorado Springs, CO 80906-3717

Mailing Address155 Lake Ave Ste 201Colorado Springs, CO 80906-3717 · (719) 375-5201 · Fax (844) 656-9696

Phone(719) 375-5201

Fax(844) 656-9696

Organization SubpartNo

Authorized OfficialMarc Van NessOwner · (719) 375-5201

Enumeration DateJanuary 27, 2015

Last NPPES UpdateJuly 21, 20212 updates tracked since enumeration

NPPES CertifiedJune 30, 2021

✔ NPI 1801286919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CO · 104909

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

155 LAKE AVE STE 201, Colorado Springs, CO 80906

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARC ROBERT VANNESS D.M.D.

Dentist (General Practice)

155 LAKE AVE STE 201
COLORADO SPRINGS, CO 80906

El Paso County (719) 375-5201

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadmoor Lake Dental's NPI number?

The NPI number for Broadmoor Lake Dental is 1801286919. It was assigned to this organization in the NPPES registry on January 27, 2015.

Where is Broadmoor Lake Dental located?

Broadmoor Lake Dental is located at 155 Lake Ave Ste 201, Colorado Springs, CO 80906. The listed phone number is (719) 375-5201.

What is Broadmoor Lake Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Broadmoor Lake Dental was last updated on July 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.