Elliott Bermudez-Colon, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2118 Issued in PR

Practice address

2940 Stanley Rd Ste 2375
Fort Sam Houston, TX 78234-2740

Phone

(210) 295-4595

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1215032057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 MOJAVE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542139",
            "telephone_number": "210-643-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 STANLEY RD STE 2375",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782342740",
            "telephone_number": "210-295-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ-COLON",
        "first_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2118",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "2118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Benson
• Melanie Diane Benson, APN, CNM
• Matthew Bentley, RN
• Scott Jared Bentley, D.O.
• Janet Marie Berg, MS, RN
• Gary Michael Bernard, M.D.
• Samantha Lyndsay Bertran, FNP
• Lindsey Lang Best, LCSW
• Brittney Betcher, R.N.
• Johnathan E Betten, PA-C

• Periodontics in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.