Active NPI
Jose David Gozalo Diaz, DDS,MS
- Prosthodontics
- Aurora, CO
National Provider Identifier
1427370154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 10102
- Practice address
- 13065 E 17TH Ave
Mail Stop F742
Aurora, CO 80045-2532 - Phone
- (303) 724-5505
- NPI assigned
- Feb 22, 2010
- Last updated
- Jan 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 23733 | TX | |
| Prosthodontics | 1223P0700X | 10102 | CO | Primary |
Addresses
Primary practice location
13065 E 17TH Ave
Mail Stop F742
Aurora, CO 80045-2532
Mailing address
13065 E 17TH Ave
Aurora, CO 80045-2532
Phone (720) 226-3434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 15, 2021 through Jan 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10102 | CO | MD | Prosthodontist |
| 23733 | TX | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1427370154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13065 E 17TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800452532",
"telephone_number": "720-226-3434",
"fax_number": "303-724-7079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13065 E 17TH AVE",
"address_2": "MAIL STOP F742",
"city": "AURORA",
"state": "CO",
"postal_code": "800452532",
"telephone_number": "303-724-5505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOZALO DIAZ",
"first_name": "JOSE",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS,MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-22",
"last_updated": "2021-01-15",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TX",
"license": "23733",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CO",
"license": "10102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.