Individual provider Active NPI

Kelly Gonzalez, DMD

  • Dentist
  • Hollywood, FL
National Provider Identifier
1952717027
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20710 Issued in FL
Practice address
9640 Stirling Rd Unit 101
Hollywood, FL 33024-8085
Phone
(954) 400-0900
Fax
(954) 947-3900
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20170 FL
Dentist 122300000X DN20710 FL Primary

Addresses

Primary practice location

9640 Stirling Rd Unit 101
Hollywood, FL 33024-8085

Mailing address

9640 Stirling Rd Unit 101
Hollywood, FL 33024-8085
Phone (954) 400-0900

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

LicenseStateTypeSpecialty
DN20170FLMDDentist
DN20710FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
My Smile Dentistry LLC Dentist CurrentSince Apr 20, 2021 Accepting new patients
Sawgrass Mills Mall Dental, PA General Practice Past Accepting new patients

Locations

9640 Stirling Rd
Unit 101
Hollywood, FL 33024
Phone (954) 400-0900

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1952717027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 STIRLING RD UNIT 101",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248085",
            "telephone_number": "954-400-0900",
            "fax_number": "954-947-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 STIRLING RD UNIT 101",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248085",
            "telephone_number": "954-400-0900",
            "fax_number": "954-947-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KELLY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20170",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.