Stephanie Ivana Gonzalez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN25895 Issued in FL

Practice address

4789 SW 148TH Ave Ste 205
Davie, FL 33330-2121

Phone

(954) 633-8496

NPI assigned

Jun 13, 2021

Last updated

Jun 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1623542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1285202614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 ROSEWOOD AVE",
            "city": "MALABAR",
            "state": "FL",
            "postal_code": "329504339",
            "telephone_number": "321-750-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4789 SW 148TH AVE STE 205",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302121",
            "telephone_number": "954-633-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "STEPHANIE",
        "middle_name": "IVANA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-13",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reinol Antonio Gonzalez, DMD
• Sabrina Gonzalez, PHARMD
• Samantha Gonzalez
• Sofia Ariel Gonzalez
• Stephanie Guerra Gonzalez
• Susan Gonzalez
• Tayler Gonzalez, PHARMD
• Tulia Marcela Gonzalez, D.D.S
• Vanessa Marie Gonzalez
• Vilma Gonzalez

• General Practice Dentistry in Davie, FL
• Providers in Davie, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; 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.