Individual provider Active NPI

Lizbeth Marie Colon-Deglans, D.M.D., M.S.

  • Periodontics
  • Carolina, PR
National Provider Identifier
1114146362
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2366 Issued in PR
Practice address
Carolina Shopping Court
Piso 6, Suite 307
Carolina, PR 00985
Phone
(787) 768-6625
Fax
(787) 768-6625
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2366 PR Primary

Addresses

Primary practice location

Carolina Shopping Court
Piso 6, Suite 307
Carolina, PR 00985

Mailing address

Carolina Shopping Court
Piso 6, Suite 307
Carolina, PR 00985
Phone (787) 768-6625

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114146362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPPING COURT",
            "address_2": "PISO 6, SUITE 307",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-768-6625",
            "fax_number": "787-768-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPPING COURT",
            "address_2": "PISO 6, SUITE 307",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-768-6625",
            "fax_number": "787-768-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON-DEGLANS",
        "first_name": "LIZBETH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.