Wayne David Gonzales, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104439 Issued in CA

Practice address

8031 Linda Vista Rd # 210
San Diego, CA 92111-5110

Phone

(858) 268-5020

NPI assigned

Sep 30, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1083255111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 WESTWOOD BLVD APT 5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346720",
            "telephone_number": "310-948-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 LINDA VISTA RD # 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115110",
            "telephone_number": "858-268-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "WAYNE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "104439",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": ".",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "8031 Linda Vista Rd # 210",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921115110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Priscilla Gonzales
• Rayleen Gonzales
• Richard Daniel Gonzales
• Serina Naomie Gonzales
• Veronica Gonzales
• Adriana Gonzalez Castillo, BT
• Karen Anahi Gonzalez Cedano
• Fernanda Gonzalez Cervantes
• Kimberly Anahy Gonzalez Davalos, MD
• Antonio Gonzalez Escobedo

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.