MEDICARE: DR. JASON ANDREW MESSINGHAM DDS, MS

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	8555	CO

General Provider Information

NPI Number	:	1952350118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON ANDREW MESSINGHAM DDS, MS

Provider Business Mailing Address
First Line	:	1050 S 8TH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-1307
Country	:	US
Telephone Number	:	719-635-2807
Fax Number	:	719-635-2965

Provider Business Practice Location Address
First Line	:	1050 S 8TH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-1307
Country	:	US
Telephone Number	:	719-635-2807
Fax Number	:	719-635-2965

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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