Individual provider Active NPI

Carlos Yanes Gonzalez, DMD

  • Dentist
  • Fort Lauderdale, FL
National Provider Identifier
1801588090
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27921 Issued in FL
Practice address
1625 E Las Olas Blvd
Fort Lauderdale, FL 33301-2357
Phone
(954) 463-5051
NPI assigned
May 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27921 FL Primary

Addresses

Primary practice location

1625 E Las Olas Blvd
Fort Lauderdale, FL 33301-2357

Mailing address

3890 SW 64TH Ave Apt 358
Davie, FL 33314-2587
Phone (786) 619-5587

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
27921FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vazquez Garcia DMD, LLC Dentist PastSince Oct 1, 2023 Accepting new patients
Ty J Eriks DMD Corp PastSince Aug 10, 2025 Accepting new patients
West Coast Dental Partners PastSince Nov 9, 2025 Accepting new patients
Bruce R. Ouellette DDS PA PastSince May 1, 2023 Accepting new patients

Organizations & group practices 4

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1801588090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 SW 64TH AVE APT 358",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333142587",
            "telephone_number": "786-619-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E LAS OLAS BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012357",
            "telephone_number": "954-463-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANES GONZALEZ",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "27921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.