Carlos A Garza Gongora, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2320 Towne Lake Parkway
Building 1300 Ste 100
Woodstock, GA 30189

Phone

(678) 445-5444

Fax

(678) 445-5552

NPI assigned

Sep 20, 2006

Last updated

Aug 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1255439840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 TOWNE LAKE PARKWAY",
            "address_2": "BUILDING 1300 STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "678-445-5444",
            "fax_number": "678-445-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 TOWNE LAKE PARKWAY",
            "address_2": "BUILDING 1300 STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "678-445-5444",
            "fax_number": "678-445-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA GONGORA",
        "first_name": "CARLOS",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013700",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan R Garber, OTR/L
• Nicole Garchitorena
• Milce Garcia Vazquez, RBT
• Carlos M Garcia, MD
• Alma Rut Gardarsdottir, LCSW
• Gastrointestinal Diagnostic Endoscopy Woodstock, LLC (Town Lake Endoscopy Center)
• Gaudio Inc (Cherokee Physiotherapy)
• Gaudio Inc. Dba Cherokee Physiotherapy
• Gaudio, Inc (Cherokee Physiotherapy)
• Maria B Gaudio

• Student in an Organized Health Care Education/Training Program in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.