Gabrielle St Germain Colon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6845 Issued in LA

Practice address

812 Park Ave
Mandeville, LA 70448-4949

Phone

(985) 626-9791

Fax

(985) 727-9791

NPI assigned

Jun 22, 2018

Reactivated

Sep 22, 2023

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

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": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1225523269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 PARK AVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704484949",
            "telephone_number": "985-626-9791",
            "fax_number": "985-727-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 PARK AVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704484949",
            "telephone_number": "985-626-9791",
            "fax_number": "985-727-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "GABRIELLE",
        "middle_name": "ST GERMAIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "deactivation_date": "2023-06-20",
        "reactivation_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018019128",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Coker
• L C Cole
• Linda Joan Collings, PH.D., M.P.
• Christopher Ray Collins, LPC, LAC, CCGC
• William F Colomb, M.D.
• Christina Colonna
• Commcare Corporation
• Community Care Center of Mandeville LLC (Heritage Manor of Mandeville)
• Complementary Medical Services
• Comprehensive Physical Therapy, LLC

• General Practice Dentistry in Mandeville, LA
• Providers in Mandeville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.