Healthcare Provider Details

I. General information

NPI: 1750265922
Provider Name (Legal Business Name): RYAN RAWLINGS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MDG, 4102 PINION DRIVE SUITE 4048
USAF ACADEMY CO
80840-4048
US

IV. Provider business mailing address

4430 BAYS WATER DR
COLORADO SPRINGS CO
80920-7621
US

V. Phone/Fax

Practice location:
  • Phone: 719-333-5586
  • Fax:
Mailing address:
  • Phone: 402-613-7360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8103
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: