Individual provider Active NPI

Jose Luis Gonzalez, DMD

  • General Practice Dentistry
  • Orocovis, PR
National Provider Identifier
1245348168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
983 Issued in PR
Practice address
15 Calle Hospital
Orocovis, PR 00720-4404
Phone
(787) 867-5740
Fax
(787) 867-5135
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

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 983 PR Primary

Addresses

Primary practice location

15 Calle Hospital
Orocovis, PR 00720-4404

Mailing address

PO Box 2102
Orocovis, PR 00720-2102
Phone (787) 867-5740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20150820010759 PR Order and Referring Only - DentistPractitioner - Dentist 8921313834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245348168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2102",
            "city": "OROCOVIS",
            "state": "PR",
            "postal_code": "007202102",
            "telephone_number": "787-867-5740",
            "fax_number": "787-867-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CALLE HOSPITAL",
            "city": "OROCOVIS",
            "state": "PR",
            "postal_code": "007204404",
            "telephone_number": "787-867-5740",
            "fax_number": "787-867-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orocovis, PR

Sources for this page

Verify at the official NPI Registry.