Roel Gonzalez, DMD, PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ROEL GONZALEZ, DMD, PA

Doing business as

San Marcos Pediatric Dentistry and Orthodontics

Practice address

1320 Wonder World Dr
San Marcos, TX 78666-7557

Phone

(512) 618-1383

Fax

(512) 353-1619

NPI assigned

Jul 30, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Roel Gonzalez, DMDNPI 1912002056

Title

Pediatric Dentist

Phone

(210) 906-7077

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• San Marcos Pediatric Dentistry and Orthodontics Doing business as

Locations

Practitioners 1

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

• Roel Gonzalez, D.M.D.

  • Pediatric Dentistry
  • San Marcos, TX
  • NPI 1912002056
  NPD Authorized official

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

{
    "created_epoch": "1501372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1013431238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WONDER WORLD DR STE 103",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667558",
            "telephone_number": "210-906-7077",
            "fax_number": "512-353-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WONDER WORLD DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667557",
            "telephone_number": "512-618-1383",
            "fax_number": "512-353-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROEL GONZALEZ, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-30",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ROEL",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "210-906-7077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376303901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Marcos Pediatric Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth Rodriguez
• Larissa Rodriguez
• Monica Rodriguez
• Trinidad P Rodriguez, LPC
• Claudia Rodwell, ATC, LAT
• William Randolph Rogers, D.O.
• Melany Rojas
• Mitzie Rojas, RD
• Lauren Deeann Rollans, PT
• Danica Michelle Romero

• Dentist in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.