Individual provider Active NPI

Dannelly B. Gonzalez, D.M.D.

  • Endodontics
  • Caguas, PR
National Provider Identifier
1508190943
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2837 Issued in PR
Practice address
500 Ave Degetau Ste 313
Caguas, PR 00725-7304
Phone
(787) 653-6210
Fax
(787) 653-5846
NPI assigned
Oct 1, 2009
Last updated
Jun 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2837 PR
Dentist 122300000X 054436 NY
Endodontics 1223E0200X 2837 PR Primary

Addresses

Primary practice location

500 Ave Degetau Ste 313
Caguas, PR 00725-7304

Mailing address

500 Ave Degetau Ste 313
Caguas, PR 00725-7304
Phone (787) 653-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20121226000354 PR Practitioner - EndodonticsPractitioner - Oral SurgeryPractitioner - Dentist 7618120643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2837PRMDPsychologist
054436NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Patricio J. Sumaza, DMD, CSP Endodontics CurrentSince Dec 1, 2012 Accepting new patients

Locations

351 Ave Hostos
Ste 211
Mayaguez, PR 00680
Phone (787) 986-3636

1003 Ave Emerito Estrada
Ste 5
San Sebastian, PR 00685
Phone (787) 986-3636

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751068800000",
    "number": "1508190943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 AVE DEGETAU STE 313",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007257304",
            "telephone_number": "787-653-6210",
            "fax_number": "787-653-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 AVE DEGETAU STE 313",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007257304",
            "telephone_number": "787-653-6210",
            "fax_number": "787-653-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DANNELLY",
        "middle_name": "B.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2837",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054436",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PR",
            "license": "2837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.