Individual provider Active NPI

Eugenio Gonzalez, DMD

  • General Practice Dentistry
  • Las Piedras, PR
National Provider Identifier
1801808407
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2471 Issued in PR
Practice address
Olympic Plaza
Suite 204
Las Piedras, PR 00771-9884
Phone
(787) 733-4488
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2471 PR Primary

Addresses

Primary practice location

Olympic Plaza
Suite 204
Las Piedras, PR 00771-9884

Mailing address

PO Box 162
Guaynabo, PR 00970-0162
Phone (787) 733-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160311000795 PR Order and Referring Only - DentistPractitioner - Dentist 7517263841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2471PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1801808407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 162",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009700162",
            "telephone_number": "787-733-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OLYMPIC PLAZA",
            "address_2": "SUITE 204",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007719884",
            "telephone_number": "787-733-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "EUGENIO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Piedras, PR

Sources for this page

Verify at the official NPI Registry.