Provider Demographics
NPI:1144297110
Name:DGS ENTERPRISES, LLC
Entity type:Organization
Organization Name:DGS ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:719-651-6776
Mailing Address - Street 1:6465 SNOWBIRD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1419
Mailing Address - Country:US
Mailing Address - Phone:719-651-6776
Mailing Address - Fax:719-388-9045
Practice Address - Street 1:6465 SNOWBIRD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1419
Practice Address - Country:US
Practice Address - Phone:719-651-6776
Practice Address - Fax:719-388-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16871219Medicaid
CO48086851Medicaid