Jorge R Gonzalez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8609 Issued in SC

Practice address

2349 Cherry Rd Ste 49
Rock Hill, SC 29732-2132

Phone

(803) 721-9179

NPI assigned

Mar 20, 2007

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dentistry of Brownsville, PC

  dba Elstar Dental

  • General Practice Dentistry
  • McAllen, TX
  • NPI 1902094600
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1366567539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 CHERRY RD STE 49",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322132",
            "telephone_number": "803-721-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 CHERRY RD STE 49",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322132",
            "telephone_number": "803-721-9179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 E US Highway 83",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "78501",
            "country_code": "US",
            "telephone_number": "956-994-0349",
            "fax_number": "956-994-0988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Carr. 129, Km. 21.8 Callejones.",
            "address_purpose": "LOCATION",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690371",
            "country_code": "US",
            "telephone_number": "787-897-3908",
            "fax_number": "787-897-1952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2232",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34542",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.