Active NPI
Jesse James Gonzalez, DDS
- General Practice Dentistry
- Kyle, TX
National Provider Identifier
1760092423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN.00205480
- Practice address
- 5401 Farm to Market 1626 #190
Kyle, TX 78640 - Phone
- (512) 601-6817
- NPI assigned
- Aug 6, 2020
- Last updated
- Mar 16, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 36450 | TX | MD | Psychologist |
| DEN.00205480 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foothills Family Dental, P.C. | General Practice | Current | Accepting new patients |
| DRS Moore & King L.L.P | General Practice | Past | 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.
-
- General Practice Dentistry
- Fort Collins, CO
- NPI 1518295377
-
- General Practice Dentistry
- Amarillo, TX
- NPI 1326240516
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.