Octavio Alberto Gonzalez, D.D.S., PHD.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9139 Issued in KY

Practice address

800 Rose Street
Room D104
Lexington, KY 40536-0297

Phone

(859) 323-1345

Fax

(859) 257-5859

NPI assigned

Feb 7, 2012

Last updated

Feb 7, 2012By 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 KY

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

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• University of Kentucky

  dba UK College of Dentistry

  • Dentist
  • Lexington, KY
  • NPI 1306929385

  General Practice

  NPD

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1578835500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 VA HEALTH SCIENCES RESEARCH BUILDING",
            "address_2": "ROOM 414",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360305",
            "telephone_number": "859-323-0125",
            "fax_number": "859-257-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET",
            "address_2": "ROOM D104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-1345",
            "fax_number": "859-257-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "OCTAVIO",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keishla Marie Gonzalez-Acosta, MSPT
• Carla Gonzalez
• Hazel Joy Camit Gonzalez, APRN
• Karina Quiterio Gonzalez
• Natasha Gonzalez, APRN
• Alan S Gooch, LCSW
• Anika Gooch, MSSW, LCSW
• Good Counsel, LLC
• Robert M Good, CSW
• Thomas Joseph Goodenow, M.D.

• General Practice Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.