Individual provider Active NPI

Delfina Elizabeth Colon-Liz, D.D.S.

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1043293863
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0442961 Issued in NY
Practice address
3467 Dekalb Ave Apt 1G
Bronx, NY 10467-2322
Phone
(718) 994-0005
NPI assigned
Nov 25, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0442961 NY Primary

Addresses

Primary practice location

3467 Dekalb Ave Apt 1G
Bronx, NY 10467-2322

Mailing address

17 Short St
Fort Lee, NJ 07024-4012
Phone (917) 519-6371

Other practice location 1

664 Academy St
New York, NY 10034-4229
Phone (212) 567-2431

Other identifiers 1

IdentifierTypeStateIssuer
01364070MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0442961NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Colon Liz Dental Office PC CurrentSince Jan 17, 2021 Accepting new patients
Colon Dental Office General Practice Past Accepting new patients

Locations

3467 DeKalb Ave
Apt 1G
Bronx, NY 10467
Phone (718) 515-6683

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1043293863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SHORT ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244012",
            "telephone_number": "917-519-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3467 DEKALB AVE APT 1G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672322",
            "telephone_number": "718-994-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "664 Academy St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100344229",
            "country_code": "US",
            "telephone_number": "212-567-2431",
            "fax_number": "212-304-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLON-LIZ",
        "first_name": "DELFINA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-25",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0442961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01364070",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.