Healthcare Provider Details

I. General information

NPI: 1982120218
Provider Name (Legal Business Name): AMANDA MARIE TOMPKINS DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9334 GRAND CORDERA PKWY
COLORADO SPRINGS CO
80924-7000
US

IV. Provider business mailing address

2606 LAKE OF THE ROCKIES DR
MONUMENT CO
80132-7500
US

V. Phone/Fax

Practice location:
  • Phone: 719-282-6666
  • Fax:
Mailing address:
  • Phone: 719-360-8130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number00203316
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: