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Provider Information for 1730675588

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DANIEL RYAN SKAGGS

Gender: MALE

Individual NPI: 1730675588

Calendar   Last Updated:  2020-10-28
  Certification Date:  2020-10-28

Details

Name Value
NPI 1730675588
Enumeration Date 2018-07-05
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 4709 OAK POINTE DR
LOUISVILLE, KY 40245-6439
United States

Phone: 561-601-9035 | Fax:
View Map External Link
Primary Practice Address 111 HERITAGE SQ
SELLERSBURG, IN 47172-1863
United States

Phone: 812-248-4880 | Fax:
View Map External Link
Secondary Practice Address 4451 VENETUCCI BLVD UNIT 160
COLORADO SPRINGS, CO 80906-4056
United States

Phone: 719-392-5354 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193400000X MULTIPLE SINGLE SPECIALTY GROUP
122300000X - Dentist
CO DEN00203667