Individual provider Active NPI

Ginga Gonzalez, D.M.D.

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1154538387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4159 Issued in AL
Practice address
4515 Southlake Pkwy
Suite 101
Birmingham, AL 35244-3317
Phone
(205) 988-5656
Fax
(205) 988-3972
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4159 AL Primary

Addresses

Primary practice location

4515 Southlake Pkwy
Suite 101
Birmingham, AL 35244-3317

Mailing address

4515 Southlake Pkwy
Suite 101
Birmingham, AL 35244-3317
Phone (205) 988-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20180613001906 AL Practitioner - Dentist 0042565145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4159ALMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154538387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SOUTHLAKE PKWY",
            "address_2": "SUITE 101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352443317",
            "telephone_number": "205-988-5656",
            "fax_number": "205-988-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 SOUTHLAKE PKWY",
            "address_2": "SUITE 101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352443317",
            "telephone_number": "205-988-5656",
            "fax_number": "205-988-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GINGA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.