Active NPI
Luiz H Gonzaga, DDS, MS
- Prosthodontics
- Gainesville, FL
National Provider Identifier
1639457575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 605
- Practice address
- 1395 Center Dr
D7-6 Box 100416
Gainesville, FL 32610-0416 - Phone
- (352) 273-6750
- NPI assigned
- Jul 26, 2011
- Last updated
- Aug 11, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 605 | FL | Primary |
Addresses
Primary practice location
1395 Center Dr
D7-6 Box 100416
Gainesville, FL 32610-0416
Mailing address
1395 Center Dr
D7-6 Box 100416
Gainesville, FL 32610-0416
Phone (352) 273-6750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160316000485 | FL | Order and Referring Only - Dentist | 0446556518 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 605 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1639457575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1395 CENTER DR",
"address_2": "D7-6 BOX 100416",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100416",
"telephone_number": "352-273-6750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1395 CENTER DR",
"address_2": "D7-6 BOX 100416",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100416",
"telephone_number": "352-273-6750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZAGA",
"first_name": "LUIZ",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-26",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "FL",
"license": "605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
- Tamara Goncalves Rezende Macieira, RN, PHD
- Daniel Alejandro Gonima, LMT
- Catherine Gonsalves, M.D.
- Kathryn A Gonyer, MOT/L
- Bianca Venezia Gonynor, APRN
- Maria M Gonzalez de Torres, DBH, LCSW, MSW
- Marinette Gonzalez Morales, MD
- Guillermina Gonzalez-Lopez, APRN
- James Gonzalez-Pola
- Sandra Natalia Gonzalez-Rodriguez, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.