Broadmoor Lake Dental
NPI 1801286919ActiveOrganization· Dentist· Colorado Springs, CO
Dentist in Colorado Springs, Colorado, registered in NPPES in January 2015. The authorized official on file is Marc Van Ness, D.M.D., Owner.
Overview
| NPI | 1801286919 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 27, 2015 |
| Last updated in NPPES | Jul 21, 2021 |
| Certified by provider | Jun 30, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 104909 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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