1295808038 NPI number — DR. JUAN L COLON DDS

Table of content: DR. JUAN L COLON DDS (NPI 1295808038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295808038 NPI number — DR. JUAN L COLON DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLON
Provider First Name:
JUAN
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295808038
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 CALLE MATTEI LLUBERAS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698-3635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-267-0028
Provider Business Mailing Address Fax Number:
787-856-2762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 CALLE MATTEI LLUBERAS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698-3635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-267-0028
Provider Business Practice Location Address Fax Number:
787-856-2762
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  D02050 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7809 . This is a "INTERNATIONAL HEATH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 41890 . This is a "SSS OPTIMO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: DN02050 . This is a "UIA HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 206964 . This is a "PREFERRED HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 26429 . This is a "AMERICAN HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 70075 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 41890 . This is a "SSS HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 41902 . This is a "LA CRUZ AZUL HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7809 . This is a "FIRST PLUS HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 41890 . This is a "CCC HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6980044 . This is a "HUMANA HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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