Alejandra Gonzalez Ferguson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN21967 Issued in FL

Practice address

3420 Bayside Lakes Blvd SE
Palm Bay, FL 32909-6813

Phone

(321) 722-0155

Fax

(321) 722-1978

NPI assigned

Jul 14, 2016

Last updated

Jul 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1821441940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 BAYSIDE LAKES BLVD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096813",
            "telephone_number": "321-722-0155",
            "fax_number": "321-722-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 BAYSIDE LAKES BLVD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096813",
            "telephone_number": "321-722-0155",
            "fax_number": "321-722-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ FERGUSON",
        "first_name": "ALEJANDRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goelz Enterprises (Prime Physical Therapy)
• Amanda Goelz, DPT, ATC
• Valarie Golombeski, LPC-ASSOCIATE
• Mayte Gomez Sosa, OTR
• Nayra Liseth Gomez-Pena, OCCUPATIONAL THERAPY
• Fernando Andres Gonzalez Gonzalez
• Joselhyne Gonzalez Valenzuela
• Alexis Geraldo Gonzalez, PHARMD
• Karla Nicole Gonzalez, APRN
• Natalie Marie Gonzalez, RBT-23-297964

• Dentist in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.