Active NPI
Carlos Rafael Colon-Bengoa, DDS
- Dentist
- Winter Garden, FL
National Provider Identifier
1609876713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN15278
- Practice address
- 1210 E Plant St
#200
Winter Garden, FL 34787-2996 - Phone
- (407) 877-4310
- Fax
- (407) 654-4582
- NPI assigned
- Jul 29, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN15278 | FL | Primary |
Addresses
Primary practice location
1210 E Plant St
#200
Winter Garden, FL 34787-2996
Mailing address
110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN15278 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609876713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S WOODLAND ST",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347873546",
"telephone_number": "407-905-8827",
"fax_number": "407-654-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 E PLANT ST",
"address_2": "#200",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347872996",
"telephone_number": "407-877-4310",
"fax_number": "407-654-4582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLON-BENGOA",
"first_name": "CARLOS",
"middle_name": "RAFAEL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN15278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Garden, FL
- Nicole Justine Cochrane, MS,CCC-SLP
- Samantha Marie Coffield
- Nicole Marie Coggins, PA-C
- Coherence Wellness
- Katia Colburn, RN
- Magda Glorie Colondres Sanchez, RPT
- Amy Erin Columbus, OTD, OTR/L
- Comfortable Care Dental Health Professionals, P.a. (Dental Care at Lake Ingram)
- Comfortable Care Dental Health Professionals, P.a. (Dental Care at Johns Lake)
- Comfortable Care Dental Health Professionals, P.a. (Lake Britt Dental Care)
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.