Ivan Christopher Colon, D.D.S.
Individual provider Active NPI General Practice Dentistry · Kapolei, HI
NPI 1952602005 · NPPES record last updated Nov 5, 2010
Key facts
- NPI
- 1952602005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DT-2426 (HI)
- Practice address
- 599 Farrington Hwy
Ste. 205
Kapolei, HI 96707-2028 - Phone
- (808) 674-9090
- NPI assigned
- Nov 5, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150804003564 | HI | Order and Referring Only - Dentist |
6507170636 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT-2426 | HI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainbow Dental Center Kapolei Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DT-2426 | HI | Yes |
Addresses
Primary practice location
599 Farrington Hwy
Ste. 205
Kapolei, HI 96707-2028
Mailing address
599 Farrington Hwy
Ste. 205
Kapolei, HI 96707-2028
Phone (808) 674-9090
Other providers in Kapolei, HI
- Alexandra Natishta-Ayana Cohen
- Shannon Colby
- Kelli Colipano
- Collaborative Counseling Center of Hawaii,LLC
- Yamilet Lyan Colon Agosto
- Nancy Christine Colvin
- Allison Jean Comlat
- Chyna Pomaikaiuluwehionala Concepcion
- Kimberley Cook
- Leslie Coons
All providers in Kapolei, HI · General Practice Dentistry in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.