Active NPI
Katrina Gonzalez, DMD
- Dentist
- Boynton Beach, FL
National Provider Identifier
1457084261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 27066
- Practice address
- 2860 S Seacrest Blvd
Boynton Beach, FL 33435-7935 - Phone
- (561) 858-6268
- NPI assigned
- Jul 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27066 | FL | Primary |
Addresses
Primary practice location
2860 S Seacrest Blvd
Boynton Beach, FL 33435-7935
Mailing address
3930 SW 60TH CT
Miami, FL 33155-5021
Phone (305) 527-6327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221020000124 | CO | Order and Referring Only - Dentist | 7719353440 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27066 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1457084261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3930 SW 60TH CT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331555021",
"telephone_number": "305-527-6327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2860 S SEACREST BLVD",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334357935",
"telephone_number": "561-858-6268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "KATRINA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-08",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "27066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boynton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.