Ryan Raquel Gonzales, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D009302 Issued in AZ

Practice address

1061 S State Route 260
Cottonwood, AZ 86326-4624

Phone

(928) 239-3254

NPI assigned

Sep 1, 2016

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1740736453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 S STATE ROUTE 260",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264624",
            "telephone_number": "928-386-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 S STATE ROUTE 260",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264624",
            "telephone_number": "928-239-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "RYAN",
        "middle_name": "RAQUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn M Lipton MD PC
• Sheri Joy Glick, MS, CCC-SLP
• Jason Robert Golec, D.C.
• Melissa Golladay, R.PH.
• Casey Goniwiecha
• Noe Israel Gonzalez
• Goodwill Industries -Cottonwood
• Amy L Gottschalk, M.D.
• Donald D Graber, M.D.
• Grace E. Jackson, MD, PLLC

• Dentist in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.