Zachary Nathan Gonzales, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

00202832 Issued in CO

Practice address

6632 W 10TH St
Ste 101
Greeley, CO 80634-9733

Phone

(970) 353-4848

Fax

(970) 356-5752

NPI assigned

Jun 22, 2015

Last updated

Jul 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• CO HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greeley Modern Dentistry, LLP

  dba Greeley Modern Dentistry

  • General Practice Dentistry
  • Greeley, CO
  • NPI 1750678439
  NPD (past)

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1023490588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6632 W 10TH ST",
            "address_2": "STE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806349733",
            "telephone_number": "970-353-4848",
            "fax_number": "970-356-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6632 W 10TH ST",
            "address_2": "STE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806349733",
            "telephone_number": "970-353-4848",
            "fax_number": "970-356-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ZACHARY",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021610",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Gonynor
• Andrea Gonzales, MSW
• Felicia Gonzales
• Khadijah Gonzales
• Kyla Dawn Gonzales
• Selene Gonzalez Maynez
• Alyssa Lauren Neuer Gonzalez, D.O.
• Angela Gonzalez, DPT
• Ashley Niccole Gonzalez
• Brooke Monique Gonzalez, DPT

• Dentist in Greeley, CO
• Providers in Greeley, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.