Bulmario Medina Gonzalez, DDS, FAACP, IBO

Primary specialty

DentistTaxonomy code 122300000X

License

35400 Issued in CA

Practice address

7950 Cherry Ave
Suite 101
Fontana, CA 92336-4022

Phone

(909) 854-5400

Fax

(909) 854-6941

NPI assigned

Oct 17, 2007

Last updated

Oct 17, 2007By the provider in NPPES

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

Enrolled in CA

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": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1932398781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 CHERRY AVE",
            "address_2": "SUITE 101",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364022",
            "telephone_number": "909-854-5400",
            "fax_number": "909-854-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 CHERRY AVE",
            "address_2": "SUITE 101",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364022",
            "telephone_number": "909-854-5400",
            "fax_number": "909-854-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "BULMARIO",
        "middle_name": "MEDINA",
        "name_prefix": "Dr.",
        "credential": "DDS, FAACP, IBO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaquelinne Gonzalez-Ruiz
• Adriana Gonzalez, DO
• Brandon Michael Gonzalez, FNP-C
• Breanna Lizette Gonzalez
• Briana Korinna Gonzalez
• Carla Iris Gonzalez, FNP-C
• Daniela Gonzalez
• Gregoria Gonzalez I
• Jasmine Gonzalez
• Jennifer Gonzalez

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.