Active NPI
Garret Gonzales, DDS
- Dentist
- Saint Louis, MO
National Provider Identifier
1083576433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2025049199
- Practice address
- 4171 Crescent Dr Ste 102
Saint Louis, MO 63129-3645 - Phone
- (314) 200-3880
- NPI assigned
- Nov 24, 2025
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2025049199 | MO | Primary |
Addresses
Primary practice location
4171 Crescent Dr Ste 102
Saint Louis, MO 63129-3645
Mailing address
9616 Bent Pine Dr Apt a
Sappington, MO 63126-3346
Phone (208) 420-4213
Other practice location 1
5712 Oakland Ave
Saint Louis, MO 63110-1318
Phone (314) 200-3880
Other practice location 2
14560 Manchester Rd Ste 25
Manchester, MO 63011-3933
Phone (314) 200-3880
Other practice location 3
1050 S 5th St
Saint Charles, MO 63301-2419
Phone (314) 200-3880
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025049199 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1083576433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9616 BENT PINE DR APT A",
"city": "SAPPINGTON",
"state": "MO",
"postal_code": "631263346",
"telephone_number": "208-420-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4171 CRESCENT DR STE 102",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631293645",
"telephone_number": "314-200-3880"
}
],
"practiceLocations": [
{
"address_1": "5712 Oakland Ave",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101318",
"country_code": "US",
"telephone_number": "314-200-3880",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14560 Manchester Rd Ste 25",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "MO",
"postal_code": "630113933",
"country_code": "US",
"telephone_number": "314-200-3880",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1050 S 5th St",
"address_purpose": "LOCATION",
"city": "Saint Charles",
"state": "MO",
"postal_code": "633012419",
"country_code": "US",
"telephone_number": "314-200-3880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALES",
"first_name": "GARRET",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-24",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2025049199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.