Ryan Joseph Gonzalez, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5471-015 Issued in WI

Practice address

902 E Main St
Winneconne, WI 54986-9782

Phone

(920) 582-4427

Fax

(920) 582-7563

NPI assigned

Jan 25, 2006

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 WI

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 and National Provider Directory roles.

• Winneconne Family Dentistry

  • General Practice Dentistry
  • Winneconne, WI
  • NPI 1760728166

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1497725063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E. MAIN STREET",
            "address_2": "PO BOX",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "54986",
            "telephone_number": "920-582-4427",
            "fax_number": "920-582-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E MAIN ST",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869782",
            "telephone_number": "920-582-4427",
            "fax_number": "920-582-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5471-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ascension Medical Group-Fox Valley Wisconsin, Inc
• Aurora Medical Group, Inc.
• Luke William Berglund
• Patrick Gerard Dowling, DDS
• Audra A Eggum, LCSW
• Joseph Walter Guerard, D.D.S.
• David J Hoenecke, RPH
• Alexandra Kellogg, D.C.
• Jennifer Krause
• Kathleen Helen Larson, MS, OTR

• All providers in Winneconne, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.