Ryan Emmanuel Gonsalves, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8414 Issued in NC

Practice address

104 Waters Edge CT
Mooresville, NC 28117-5513

Phone

(919) 619-4166

NPI assigned

Feb 11, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Gonsalves and Wolff, DDS PLLC

  • General Practice Dentistry
  • Mooresville, NC
  • NPI 1184858128
  NPD (past) Authorized official
• County of Surry & Surry County Welfare Department

  • Public Health or Welfare Agency
  • Dobson, NC
  • NPI 1790825206
  NPD (past)

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1497994768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WATERS EDGE CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175513",
            "telephone_number": "919-619-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WATERS EDGE CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175513",
            "telephone_number": "919-619-4166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Hamby Rd",
            "address_purpose": "LOCATION",
            "city": "Dobson",
            "state": "NC",
            "postal_code": "270178471",
            "country_code": "US",
            "telephone_number": "336-401-8405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "RYAN",
        "middle_name": "EMMANUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NC",
            "license": "8414",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Livingstone Glick III, D.C.
• Emily Smith Godfrey, LCSW
• Alexis Godley
• Jessie Watts Gogg, LCSW
• Gonsalves and Wolff, DDS PLLC
• Michel Gonzalez Nunez, FNP-C
• Heather Nichole Gonzalez, FNP-C
• Vanessa Gonzalez
• Joshua N Gooding
• Mark Allen Goodson, MD

• Dentist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.