Individual provider Active NPI

Roy Gonzalez Jr., D.D.S.,M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Antonio, TX
National Provider Identifier
1750504494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12834 Issued in TX
Practice address
1100 NW Loop 410
Suite 560
San Antonio, TX 78213-2263
Phone
(210) 344-9295
Fax
(210) 979-0348
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12834 TX Primary

Addresses

Primary practice location

1100 NW Loop 410
Suite 560
San Antonio, TX 78213-2263

Mailing address

1100 NW Loop 410
Suite 560
San Antonio, TX 78213-2263
Phone (210) 344-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12834TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alamo City Orthodontics, PLLC Orthodontics and Dentofacial Orthopedics PastSince Jul 17, 2022 Accepting new patients
Roy R. Gonzalez,DDS,MSD,PA Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750504494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NW LOOP 410",
            "address_2": "SUITE 560",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132263",
            "telephone_number": "210-344-9295",
            "fax_number": "210-979-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NW LOOP 410",
            "address_2": "SUITE 560",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132263",
            "telephone_number": "210-344-9295",
            "fax_number": "210-979-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ROY",
        "name_suffix": "Jr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "12834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.