Provider Demographics
NPI:1487884383
Name:COLON, ENID C (DDS)
Entity type:Individual
Prefix:DR
First Name:ENID
Middle Name:C
Last Name:COLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 N GEORGE MASON DR STE 470
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3677
Mailing Address - Country:US
Mailing Address - Phone:703-522-9292
Mailing Address - Fax:703-522-9096
Practice Address - Street 1:1635 N GEORGE MASON DR STE 470
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3677
Practice Address - Country:US
Practice Address - Phone:703-522-9292
Practice Address - Fax:703-522-9096
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-26
Last Update Date:2009-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice