Gustavo Alberto Gonzalez-Nieto, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23863 Issued in TX

Practice address

109 N 4TH Ave
Teague, TX 75860-1601

Phone

(254) 739-2533

Fax

(254) 739-2534

NPI assigned

May 19, 2008

Last updated

Mar 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gonzalez Dentistry, Inc

  • General Practice Dentistry
  • Teague, TX
  • NPI 1699307140
  NPD Authorized official

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1487811352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N 4TH AVE",
            "city": "TEAGUE",
            "state": "TX",
            "postal_code": "758601601",
            "telephone_number": "254-739-2533",
            "fax_number": "254-739-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 4TH AVE",
            "city": "TEAGUE",
            "state": "TX",
            "postal_code": "758601601",
            "telephone_number": "254-739-2533",
            "fax_number": "254-739-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-NIETO",
        "first_name": "GUSTAVO",
        "middle_name": "ALBERTO",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dew Isd
• Burma Dugger, DDS
• Fairfield Hospital District (Freestone Health Clinic at Teague)
• Lauren Hirsch George, M.S. CCC-SLP
• Gonzalez Dentistry, Inc
• Veronica Harris, FNP
• Raechel Christeene Hataway, MS, CF-SLP
• JHS Operations, LLC (Elara Caring)
• Robin Louise Johnson, FNP-C
• Jaggar Kennedy

• General Practice Dentistry in Teague, TX
• Providers in Teague, 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 Mar 7, 2016; 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.

Verify at the official NPI Registry.