Kathleen Reyes Gonzales, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13040 Issued in CT

Practice address

27005 76TH Ave
New Hyde Park, NY 11040-1402

Phone

(718) 470-3076

NPI assigned

Mar 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Locations

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.

• Everyday Smiles Pediatric Dentistry

  • Pediatric Dentistry
  • New Windsor, NY
  • NPI 1548061583
  NPD Authorized official

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1386102721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 COMMUNITY DR APT 1J",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303835",
            "telephone_number": "914-882-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-3076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1843 Hertel Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142163006",
            "country_code": "US",
            "telephone_number": "914-882-9882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "KATHLEEN",
        "middle_name": "REYES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "13040",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "13040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sindhu Gollapalli, MD
• Armin Gollogly, M.D.
• Noreen Elizabeth Gomillion, PA
• Edward J Gona, NP
• Rizwan Akram Gondal, MD
• Noel Jose Gonzalez Rosales, M.D.
• Rafael A. Gonzalez-Alonso, M.D.
• Dario Gonzalez
• Michael Gonzalez, MS., LAT
• Good Neighbor Acupuncture, P.C.

• Pediatric Dentistry in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.