Individual provider Active NPI

Jesse James Gonzalez, DDS

  • General Practice Dentistry
  • Kyle, TX
National Provider Identifier
1760092423
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00205480 Issued in CO
Practice address
5401 Farm to Market 1626 #190
Kyle, TX 78640
Phone
(512) 601-6817
NPI assigned
Aug 6, 2020
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 36450 TX
General Practice Dentistry 1223G0001X DEN.00205480 CO Primary

Addresses

Primary practice location

5401 Farm to Market 1626 #190
Kyle, TX 78640

Mailing address

8733 Mina Dr
Austin, TX 78747-3766
Phone (956) 490-6275

Other practice location 1

102 Wonder World Dr Ste 101
San Marcos, TX 78666-6080
Phone (737) 727-4794

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

State licenses

LicenseStateTypeSpecialty
36450TXMDPsychologist
DEN.00205480COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Family Dental, P.C. General Practice CurrentSince Jul 7, 2024 Accepting new patients
DRS Moore & King L.L.P General Practice PastSince Aug 1, 2020 Accepting new patients

Locations

605 S College Ave
#100
Fort Collins, CO 80524
Phone (970) 482-6841

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1760092423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8733 MINA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787473766",
            "telephone_number": "956-490-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 FARM TO MARKET 1626 #190",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "78640",
            "telephone_number": "512-601-6817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Wonder World Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786666080",
            "country_code": "US",
            "telephone_number": "737-727-4794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-06",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36450",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00205480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.