Active NPI
Elaine Anne Gonzales, DDS
- General Practice Dentistry
- New York, NY
National Provider Identifier
1629136072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 051798
- Practice address
- 853 Broadway
Suite 2001
New York, NY 10003-4703 - Phone
- (212) 533-4606
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 051798 | NY | Primary |
Addresses
Primary practice location
853 Broadway
Suite 2001
New York, NY 10003-4703
Mailing address
6750 Thornton PL
Apt 6C
Forest Hills, NY 11375-4171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051798 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629136072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6750 THORNTON PL",
"address_2": "APT 6C",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "853 BROADWAY",
"address_2": "SUITE 2001",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100034703",
"telephone_number": "212-533-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "ELAINE",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "051798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.