Jesus A. Gomez, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30463 Issued in TX

Practice address

6421 Saratoga Blvd
Building 101
Corpus Christi, TX 78414-3479

Phone

(361) 992-3873

Fax

(361) 992-7328

NPI assigned

Apr 25, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

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 and National Provider Directory roles.

• El Paso Oral Surgery Center, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • El Paso, TX
  • NPI 1699133801
  NPD (past)
• R. Bryan Gulley DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Corpus Christi, TX
  • NPI 1689030876
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1396701561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 SARATOGA BLVD",
            "address_2": "BUILDING 101",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784143479",
            "telephone_number": "361-992-3873",
            "fax_number": "361-992-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 SARATOGA BLVD",
            "address_2": "BUILDING 101",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784143479",
            "telephone_number": "361-992-3873",
            "fax_number": "361-992-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JESUS",
        "middle_name": "A.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "30463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0757772-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssia Jo'Shan Golightly, RD
• Peter A Golleck, M.S.,CCC/SLP
• Adrian Perez Gomez
• Celia Yazmin Gomez, MD
• Erik Sharkey Gomez, FNP-C
• Jose Mario Gomez, PHD, LPC
• Maisie Ann Gomez, NNP
• Ramona Gomez
• Robert Daniel Gomez
• Savannah Gomez

• Oral and Maxillofacial Surgery (Dentist) in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.