Anthony D Gonzales, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DD1351 Issued in NM

Practice address

219 Courthourse Rd
Los Lunas, NM 87031

Phone

(505) 865-4341

Fax

(505) 865-4954

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

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.

• SB Dental LLC

  • Dental Clinic/Center
  • Los Lunas, NM
  • NPI 1376055574
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124199567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1197",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870311197",
            "telephone_number": "505-865-4341",
            "fax_number": "505-865-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 COURTHOURSE RD",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "87031",
            "telephone_number": "505-865-4341",
            "fax_number": "505-865-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ANTHONY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD1351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annalisa Golowacz, MA, LPCC
• Dora Sandra Gomez, B.A., M.S.
• Roberto Matthew Gomez, PHARMD
• Alysha Gonzales
• Angelica Maria Gonzales
• Elsa Marie Gonzales, MSN, NP-C
• Fermin Andres Gonzales
• Isaac Gonzales
• Natalia Elena Gonzales
• Sandra Gonzales, LMHC

• Dentist in Los Lunas, NM
• Providers in Los Lunas, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.