Active NPI
Eric Isaias Colon, RDH
- Dental Hygienist
- Minneapolis, MN
National Provider Identifier
1801568407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H11188
- Practice address
- 636 Broadway St NE
Minneapolis, MN 55413-2151 - Phone
- (507) 380-8440
- NPI assigned
- Oct 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H11188 | MN | Primary |
Addresses
Primary practice location
636 Broadway St NE
Minneapolis, MN 55413-2151
Mailing address
1681 Thomas Ave
Saint Paul, MN 55104-2266
Phone (507) 380-8440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H11188 | Medicaid | MN |
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 |
|---|---|---|---|
| H11188 | MN | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1801568407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1681 THOMAS AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551042266",
"telephone_number": "507-380-8440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "636 BROADWAY ST NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554132151",
"telephone_number": "507-380-8440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLON",
"first_name": "ERIC",
"middle_name": "ISAIAS",
"name_prefix": "Mr.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-01",
"last_updated": "2021-10-01",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MN",
"license": "H11188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H11188",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.