Individual provider Active NPI

Michael Ray Gomez, D.D.S

  • General Practice Dentistry
  • Santa Maria, CA
National Provider Identifier
1619941028
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33583 Issued in CA
Practice address
2151 S College Dr
Suite 202
Santa Maria, CA 93455-1302
Phone
(805) 922-3939
Fax
(805) 922-9241
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33583 CA Primary

Addresses

Primary practice location

2151 S College Dr
Suite 202
Santa Maria, CA 93455-1302

Mailing address

2151 S College Dr
Ste 202
Santa Maria, CA 93455-1305
Phone (805) 922-3939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160413000500 CA Order and Referring Only - DentistPractitioner - Dentist 6305144072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33583CAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619941028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 S COLLEGE DR",
            "address_2": "STE 202",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551305",
            "telephone_number": "805-922-3939",
            "fax_number": "805-922-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 S COLLEGE DR",
            "address_2": "SUITE 202",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551302",
            "telephone_number": "805-922-3939",
            "fax_number": "805-922-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.