Gonzales Dental Corporation

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

26408 Issued in CA

Legal business name

GONZALES DENTAL CORPORATION

Practice address

11968 Bernardo Plaza Drive
San Diego, CA 92128

Phone

(858) 521-0000

Fax

(858) 521-0404

NPI assigned

Sep 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Richard Gonzales, DDS

Title

President

Phone

(858) 521-0000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1285002048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11968 BERNARDO PLAZA DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92128",
            "telephone_number": "858-521-0000",
            "fax_number": "858-521-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11968 BERNARDO PLAZA DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92128",
            "telephone_number": "858-521-0000",
            "fax_number": "858-521-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALES DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-521-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "26408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Joseph Gontang, PH.D.
• Gilbert Alexander Gontes
• Jennifer Eunhyea Gonyea, IDC
• Gabriel Luis Blando Gonzaga, PHARMD
• Laura Gonzaga
• Adriana Anita Gonzales-Hernandez, LCSW, DSW
• Laarni Evangelista Gonzales-Naval, M.D.
• Alexis Reyna Gonzales
• Alyson Gonzales
• Alyssa Gonzales

• Health Maintenance Organization in San Diego, CA
• Providers in San Diego, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.