Active NPI
Manuel A Gonzalez, DMD
- Pediatric Dentistry
- San Juan, PR
National Provider Identifier
1821066812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 835
- Practice address
- 601 Calle Lodi
Villa Capri
San Juan, PR 00924-3844 - Phone
- (787) 755-7802
- Fax
- (787) 755-8618
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 835 | PR | Primary |
Addresses
Primary practice location
601 Calle Lodi
Villa Capri
San Juan, PR 00924-3844
Mailing address
601 Calle Lodi
Villa Capri
San Juan, PR 00924-3844
Phone (787) 755-7802
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 |
|---|---|---|---|
| 835 | PR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424649600000",
"number": "1821066812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 CALLE LODI",
"address_2": "VILLA CAPRI",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009243844",
"telephone_number": "787-755-7802",
"fax_number": "787-755-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CALLE LODI",
"address_2": "VILLA CAPRI",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009243844",
"telephone_number": "787-755-7802",
"fax_number": "787-755-8618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MANUEL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2015-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PR",
"license": "835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.