Roel Gonzalez, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

25258 Issued in TX

Practice address

1320 Wonder World Dr Ste 103
San Marcos, TX 78666-7558

Phone

(512) 353-5500

Fax

(512) 353-1619

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roel Gonzalez, DMD, PA

  dba San Marcos Pediatric Dentistry and Orthodontics

  • Dentist
  • San Marcos, TX
  • NPI 1013431238
  NPD Authorized official
• San Antonio Pediatric Dentistry, PLLC

  dba San Antonio Pediatric Dentistry and Orthodontics

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1427513316
  NPD

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1912002056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WONDER WORLD DR STE 103",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667558",
            "telephone_number": "512-353-5500",
            "fax_number": "512-353-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WONDER WORLD DR STE 103",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667558",
            "telephone_number": "512-353-5500",
            "fax_number": "512-353-1619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17026 Bulverde Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782474700",
            "country_code": "US",
            "telephone_number": "210-944-8111",
            "fax_number": "210-944-8113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ROEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "25258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Gomez
• Amy Breedlove Gonzales, PA-C
• Stephanie Gonzales
• Joshua Albert Gonzalez-Moreno, CF-SLP
• Maria Cristela Gonzalez, LCSW
• Sheryle D. Gordon, PHD
• Kaylee Frances Gott
• Cathrin Gould, LCSW, LCDC,
• Michael J Grady, M.D.
• Graham a Hamilton

• Pediatric Dentistry in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.