NPIMap

Organization Active NPI

Pedro Luis Gonzalez DMD Inc

  • Endodontics
  • Lake Elsinore, CA
National Provider Identifier
1003307844
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
55443 Issued in CA
Legal business name
PEDRO LUIS GONZALEZ DMD INC
Practice address
31569 Canyon Estates Dr Ste 239
Lake Elsinore, CA 92532-0470
Phone
(951) 399-0900
Fax
(951) 399-0948
NPI assigned
May 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Authorized official

Name
Ms. Eliza Lopez
Title
Office Administrator
Phone
(951) 399-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 55443 CA Primary

Addresses

Primary practice location

31569 Canyon Estates Dr Ste 239
Lake Elsinore, CA 92532-0470

Mailing address

31569 Canyon Estates Dr Ste 239
Lake Elsinore, CA 92532-0470
Phone (951) 399-0900

National Provider Directory

National Provider Directory

Locations

31569 Canyon Estates Dr
Ste 239
Lake Elsinore, CA 92532
Phone (951) 399-0900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1003307844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR STE 239",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320470",
            "telephone_number": "951-399-0900",
            "fax_number": "951-399-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR STE 239",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320470",
            "telephone_number": "951-399-0900",
            "fax_number": "951-399-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDRO LUIS GONZALEZ DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ELIZA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "951-399-0900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "55443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.