Individual provider Active NPI

Pablo L Gonzalez, DMD

  • Dentist
  • Redding, CA
National Provider Identifier
1063702322
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60042 Issued in CA
Practice address
1201 Industrial St
Redding, CA 96002-0757
Phone
(530) 229-5000
NPI assigned
Apr 7, 2011
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35903 TX
Dentist 122300000X 60042 CA Primary

Addresses

Primary practice location

1201 Industrial St
Redding, CA 96002-0757

Mailing address

1600 N Sarah Dewitt Dr Ste 206
Gonzales, TX 78629-2714
Phone (702) 748-8244

Other practice location 1

1600 N Sarah DeWitt Dr Ste 206
Gonzales, TX 78629-2714
Phone (026) 267-0447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60042CAMDDentist
35903TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1063702322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N SARAH DEWITT DR STE 206",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786292714",
            "telephone_number": "702-748-8244",
            "fax_number": "702-997-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 INDUSTRIAL ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020757",
            "telephone_number": "530-229-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Sarah DeWitt Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "TX",
            "postal_code": "786292714",
            "country_code": "US",
            "telephone_number": "026-267-0447",
            "fax_number": "026-267-0447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "PABLO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35903",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.