Individual provider Active NPI

Reinol Ignacio Gonzalez

  • Dentist
  • Sunrise, FL
National Provider Identifier
1376165324
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN24875 Issued in FL
Practice address
7800 W Oakland Park Blvd Ste 114F
Sunrise, FL 33351-1122
Phone
(954) 741-5006
NPI assigned
May 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24875 FL Primary

Addresses

Primary practice location

7800 W Oakland Park Blvd Ste 114F
Sunrise, FL 33351-1122

Mailing address

14351 SW 29TH CT
Davie, FL 33330-1037
Phone (954) 258-3902

Other practice location 1

4789 Volunteer Rd Ste 205
Davie, FL 33330-2121
Phone (954) 252-5911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN24875FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Dental Services 2 LLC CurrentSince Sep 5, 2021 Accepting new patients
Tommie Dental, Inc CurrentSince Jan 12, 2025 Accepting new patients

Locations

7800 W Oakland Park Blvd
Ste 114F
Sunrise, FL 33351
Phone (954) 741-5006

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1376165324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14351 SW 29TH CT",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333301037",
            "telephone_number": "954-258-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 W OAKLAND PARK BLVD STE 114F",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333511122",
            "telephone_number": "954-741-5006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4789 Volunteer Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333302121",
            "country_code": "US",
            "telephone_number": "954-252-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "REINOL",
        "middle_name": "IGNACIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-13",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.