Federico Gonzalez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31121 Issued in TX

Practice address

8714 Fredericksburg Rd Ste 106
San Antonio, TX 78240-1224

Phone

(210) 910-1111

NPI assigned

Jul 19, 2011

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 15, 2021 through Nov 15, 2027

Medicare enrollment (NPD)

Not 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.

• Pearl Dentistry PLLC

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1538565627
  NPD (past)

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1437447984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8714 FREDERICKSBURG RD STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401224",
            "telephone_number": "210-910-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8714 FREDERICKSBURG RD STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401224",
            "telephone_number": "210-910-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "FEDERICO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31121",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Joseph Gonzalez
• Erica A Gonzalez
• Erika Gabriela Gonzalez, MD
• Esmeralda Gonzalez, BSN, RN
• Eva Laura Gonzalez
• Fernando Gonzalez Jr., LPC
• Gabriel B Gonzalez, MD
• Gabriel E Gonzalez, OTD, OTR/L
• Gabriela Gonzalez, MD
• Gabriela Maria Gonzalez, PA

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.

Verify at the official NPI Registry.