P. Gonzalez DDS a Prof Corp

Primary specialty

DentistTaxonomy code 122300000X

License

46808 Issued in CA

Legal business name

P. GONZALEZ DDS A PROF CORP

Practice address

440 W Foothill Blvd
Rialto, CA 92376-4953

Phone

(909) 961-2126

Fax

(909) 961-2136

NPI assigned

Apr 30, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Pedro P Gonzalez, DDS

Title

Dentist

Phone

(909) 961-2126

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1447660428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 W FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923764953",
            "telephone_number": "909-961-2126",
            "fax_number": "909-961-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923764953",
            "telephone_number": "909-961-2126",
            "fax_number": "909-961-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P. GONZALEZ DDS A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "909-961-2126",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Rialto, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.