Active NPI
Jesica Gonzalez, DDS
- Pediatric Dentistry
- Bakersfield, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DDS104560
- Practice address
- 625 34TH St Ste And200
Bakersfield, CA 93301-2305 - Phone
- (833) 678-2781
- Fax
- (661) 368-0618
- NPI assigned
- Apr 16, 2019
- Last updated
- Mar 30, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DDS104560 | CA | Primary |
Addresses
Primary practice location
625 34TH St Ste And200
Bakersfield, CA 93301-2305
Mailing address
625 34TH St Ste And200
Bakersfield, CA 93301-2305
Phone (833) 678-2781
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS104560 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinica Sierra Vista | Current | Accepting new patients | |
| Clinica Sierra Vista | Current | Accepting new patients | |
| Clinica Sierra Vista | Current | Accepting new patients |
Locations
1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131
625 34th St
Ste 100200
Bakersfield, CA 93301
Phone (833) 578-2781
Organizations & group practices 3
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.
-
dba East Bakersfield Community Health Center
- Federally Qualified Health Center (FQHC)
- Bakersfield, CA
- NPI 1861494338
-
dba Delano Walk In Clinic
- Federally Qualified Health Center (FQHC)
- Delano, CA
- NPI 1427699396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648598400000",
"number": "1700449600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 34TH ST STE AND200",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933012305",
"telephone_number": "833-678-2781",
"fax_number": "661-368-0618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 34TH ST STE AND200",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933012305",
"telephone_number": "833-678-2781",
"fax_number": "661-368-0618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JESICA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-16",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "DDS104560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.