Cuauhtemoc Gonzalez, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

101166 Issued in CA

Practice address

5420 Park Dr
Rocklin, CA 95765-5562

Phone

(916) 435-5230

NPI assigned

Apr 20, 2015

Last updated

Jul 15, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

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.

• Ca Gonzalez Dental Corp

  dba Placer Smiles Pediatric Dentistry

  • Pediatric Dentistry
  • Lincoln, CA
  • NPI 1992427082
  NPD Authorized official
• Crutchfield Pediatric Dental Group

  dba Roseville Kids Dentist

  • Pediatric Dentistry
  • Rocklin, CA
  • NPI 1033639463
  NPD (past)
• Ryan Wittwer DDS & Joseph Rawlins DDS

  dba Sunrise Pediatric Dentistry

  • Pediatric Dentistry
  • Fair Oaks, CA
  • NPI 1275887374
  NPD (past)
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  NPD (past)

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1366839193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 PARK DR",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655562",
            "telephone_number": "916-435-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 PARK DR",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655562",
            "telephone_number": "916-435-5230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1253 Pleasant Grove Blvd Ste 190",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956786983",
            "country_code": "US",
            "telephone_number": "916-773-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CUAUHTEMOC",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "101166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandis Lynn Gonzales
• Nadja R Gonzales
• Stacy Gonzales, CPE
• Alex Gonzalez, PA
• Alexis Gonzalez
• Justine Gonzalez
• Marina Rene Gonzalez
• Victoria Lizzeth Gonzalez
• Dianna J Goodliffe
• Jonathan Gordon, CMT

• Pediatric Dentistry in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.