Active NPI
Mario Cesar Gonzalez, DDS
- General Practice Dentistry
- San Fernando, CA
National Provider Identifier
1083013320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 112564
- Practice address
- 760 Harding Ave
San Fernando, CA 91340-2019 - Phone
- (818) 919-9092
- NPI assigned
- Aug 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 112564 | CA | Primary |
Addresses
Primary practice location
760 Harding Ave
San Fernando, CA 91340-2019
Mailing address
760 Harding Ave
San Fernando, CA 91340-2019
Phone (818) 919-9092
Other names 1
- Mario Cesar Gonzalez Villalobos
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
801 S Chevy Chase Dr
Suite 250
Glendale, CA 91205-4433
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112564 | CA | MD | Marriage & Family Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Glendale, CA
- NPI 1356362743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1083013320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 HARDING AVE",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913402019",
"telephone_number": "818-919-9092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 HARDING AVE",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913402019",
"telephone_number": "818-919-9092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MARIO",
"middle_name": "CESAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-21",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "112564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIO",
"last_name": "GONZALEZ VILLALOBOS",
"middle_name": "CESAR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Fernando, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.