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General NPI Number Information
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NPI Number | 1639609811
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Entity Type | Individual
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Provider Name | ADAM VEGA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 04/22/2023
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Provider Practice Location Address
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Address Line | 625 N CASCADE AVE STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-3271
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Country | US
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Telephone | 719-633-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 625 N CASCADE AVE STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-3271
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Country | US
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Telephone | 719-633-5501
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10877277-9921
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D010623
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00203349
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33029
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License Number State | TX
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