Mary Ann NMN Gonzalez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31614 Issued in CA

Practice address

6991 N State St
Redwood Valley, CA 95470-9629

Phone

(707) 485-5115

NPI assigned

Feb 2, 2007

Sex

Female

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 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

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Consolidated Tribal Health Project, Inc.

  • Health Service Clinic/Center
  • Redwood Valley, CA
  • NPI 1003826009
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740328483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8475 UVA DR",
            "city": "REDWOOD VALLEY",
            "state": "CA",
            "postal_code": "954706224",
            "telephone_number": "707-485-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6991 N STATE ST",
            "city": "REDWOOD VALLEY",
            "state": "CA",
            "postal_code": "954709629",
            "telephone_number": "707-485-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARY ANN",
        "middle_name": "NMN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adasha Rafael Garcia
• Robert S Gitlin, D.O.
• Kimberlee Suzanne Golding
• Vanessa Gomez
• Jesus Gonzalez Orozco
• Anabell Gregory
• Chloe Hankins
• Ann Louise Kahle Horton, MFT
• Pauline Mathilda Hurme, MFT
• Tesia Iachella

• General Practice Dentistry in Redwood Valley, CA
• Providers in Redwood Valley, CA by specialty
• General Practice Dentistry in California

• 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.
• 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.