Jason R Gong, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104405 Issued in CA

Practice address

3440 Lomita Blvd Ste 340
Torrance, CA 90505-4887

Phone

(310) 530-9893

NPI assigned

Jun 7, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1740773423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5614 WHITE CT",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031864",
            "telephone_number": "559-892-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 LOMITA BLVD STE 340",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054887",
            "telephone_number": "310-530-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "JASON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha P Gomez
• Sophia Gomez, M.S., CCC-SLP
• Stephanie Gomez
• Vanessa Gomez
• Vikram Baldini Gondhalekar
• Dustin Thomas Gonzaga-Beaver, OTR/L
• Myriah Rae Gonzales-Oliva
• Elyse Gonzales, MD
• Hailey Raine Gonzales
• Jasmine Gonzales

• General Practice Dentistry in Torrance, CA
• Providers in Torrance, 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 Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.