Martha Elena De la Iglesia - Gonzalez, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN11242 Issued in FL

Practice address

4849 Volunteer Rd
Southwest Ranches, FL 33330-2129

Phone

(954) 252-5911

Fax

(954) 434-8075

NPI assigned

Dec 19, 2006

Last updated

Sep 7, 2016By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1578626453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 SW 148TH AVE",
            "address_2": "SUITE #205",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302119",
            "telephone_number": "954-252-5911",
            "fax_number": "954-434-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 VOLUNTEER RD",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333302129",
            "telephone_number": "954-252-5911",
            "fax_number": "954-434-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA IGLESIA - GONZALEZ",
        "first_name": "MARTHA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cely J Cole, RPH
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• Anthony M. Crothers, D.C.
• Donn W. Crothers, P.T.A./L.M.T.
• Matthew Delgado
• Rose L Delva, MD/MSN/FNP/APRN
• Camila V Diaz
• Odalys Downs
• Dr Laura Clune & Assoc

• Dentist in Southwest Ranches, FL
• Providers in Southwest Ranches, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.