Active NPI
Susana Gonzalez, DMD
- Dentist
- Miami Lakes, FL
National Provider Identifier
1457654824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN17960
- Practice address
- 16010 NW 57TH Ave Unit 130
Miami Lakes, FL 33014-6710 - Phone
- (786) 536-9411
- Fax
- (305) 515-3997
- NPI assigned
- Dec 7, 2010
- Last updated
- Jun 25, 2017
- 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 | DN17960 | FL | Primary |
Addresses
Primary practice location
16010 NW 57TH Ave Unit 130
Miami Lakes, FL 33014-6710
Mailing address
16010 NW 57TH Ave Unit 130
Miami Lakes, FL 33014-6710
Phone (786) 536-9411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20170913001775 | FL | Order and Referring Only - Other (Physician) | 0244503282 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498348800000",
"number": "1457654824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16010 NW 57TH AVE UNIT 130",
"city": "MIAMI LAKES",
"state": "FL",
"postal_code": "330146710",
"telephone_number": "786-536-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16010 NW 57TH AVE UNIT 130",
"city": "MIAMI LAKES",
"state": "FL",
"postal_code": "330146710",
"telephone_number": "786-536-9411",
"fax_number": "305-515-3997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "SUSANA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-07",
"last_updated": "2017-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN17960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Lakes, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2017; 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.