Agdha M. Colon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17219 Issued in FL

Practice address

1379 E Vine St
Kissimmee, FL 34744-3603

Phone

(407) 933-8686

Fax

(407) 933-2262

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1487614533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 SPRING PARK LOOP",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 E VINE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443603",
            "telephone_number": "407-933-8686",
            "fax_number": "407-933-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "AGDHA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000333500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Carmen Colon Melendez, DDS
• Stefany Colon Moreira
• Charlie Obert Colon Rodriguez
• Ildmarie Colon-Arocho
• Edna Colon-Lopez
• Aida Michelle Colon, APRN
• Carmen Colon
• Johaira Colon, PHARM D
• Marisel Colon, COTA
• Milagros Colon, LMHC

• General Practice Dentistry in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.