Gonzalez Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46260 Issued in CA

Legal business name

GONZALEZ PROFESSIONAL DENTAL CORPORATION

Practice address

426 S San Vicente Blvd
Los Angeles, CA 90048-4108

Phone

(310) 360-0767

Fax

(310) 659-2326

NPI assigned

Apr 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Aleli Escalante Gonzalez, D.D.S.

Title

D.D.S.

Phone

(310) 360-0767

Specialties & licenses 1

Addresses

Tax ID family

Gonzalez Professional Dental Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gonzalez Professional Dental Corporation

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1558489849
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Val Verde Gonzalez, D.M.D.

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1508083056
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134347982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 S SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484108",
            "telephone_number": "310-360-0767",
            "fax_number": "310-659-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 S SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484108",
            "telephone_number": "310-360-0767",
            "fax_number": "310-659-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALEZ PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ALELI",
        "authorized_official_middle_name": "ESCALANTE",
        "authorized_official_title_or_position": "D.D.S.",
        "authorized_official_telephone_number": "310-360-0767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maribel Gonzalez Miranda, AMFT
• Vianeth Gonzalez Muro
• Priscilla J Gonzalez Nevarez, LCSW
• Edgar Gonzalez Olea
• Margarita Gonzalez Pelaez
• Gonzalez Professional Dental Corporation
• Ariana Gonzalez Rebollar
• Liliana Veronica Gonzalez Romero
• Mayda Lizeth Gonzalez Soto, MSW
• William E Gonzalez Torres

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 22, 2020; 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.