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NPI Code Detail

MEDICARE: DR. RYAN M TEAGARDIN DMD

MEDICARE:  DR. RYAN M TEAGARDIN  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12341536-9921UT
2122300000XDentistDEN.00205916CO

General Provider Information

NPI Number : 1659943371
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN M TEAGARDIN DMD
Provider Business Mailing Address
First Line : 1667 COCHRANE CIR BLDG 7495
Second Line :
City : FORT CARSON
State : CO
Zip : 80913-4603
Country : US
Telephone Number : 719-526-5537
Fax Number :
Provider Business Practice Location Address
First Line : 6376 SAN MATEO DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80911-4015
Country : US
Telephone Number : 815-262-4840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2021
Last Update Date : 04/14/2025

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Directions to “ DR. RYAN M TEAGARDIN DMD” Practice Location

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