Dr. Diego H. Gonzalez-Ortiz, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR. DIEGO H. GONZALEZ-ORTIZ, DDS, PLLC

Doing business as

Supreme Dental of Wadesboro

Practice address

307 N Green St
Wadesboro, NC 28170-2182

Phone

(704) 465-2210

Fax

(704) 465-2214

NPI assigned

Dec 3, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Diego H. Gonzalez, DDS

Title

Dentist

Phone

(704) 465-2210

Specialties & licenses 1

Addresses

Other names 1

• Supreme Dental of Wadesboro Doing business as

Locations

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1891265831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N GREEN ST",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281702182",
            "telephone_number": "704-465-2210",
            "fax_number": "704-465-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N GREEN ST",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281702182",
            "telephone_number": "704-465-2210",
            "fax_number": "704-465-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DIEGO H. GONZALEZ-ORTIZ, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "704-465-2210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supreme Dental of Wadesboro",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Supreme Dental of Wadesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Wadesboro, NC
• Providers in Wadesboro, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.