Individual provider Active NPI

David Gonzalez-Mendez, D.D.S.

  • General Practice Dentistry
  • Chula Vista, CA
National Provider Identifier
1982603551
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1958 Issued in PR
Practice address
510 Broadway Ste 4
Chula Vista, CA 91910-5306
Phone
(619) 476-9400
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1958 PR Primary

Addresses

Primary practice location

510 Broadway Ste 4
Chula Vista, CA 91910-5306

Mailing address

510 Broadway Ste 4
Chula Vista, CA 91910-5306
Phone (619) 476-9400

Other practice location 1

#35 Munoz Rivera St.
2nd floor Ste #2
Rincon, PR 00677-1816
Phone (787) 823-3363

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
1958PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1982603551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BROADWAY STE 4",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105306",
            "telephone_number": "619-476-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BROADWAY STE 4",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105306",
            "telephone_number": "619-476-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "#35 Munoz Rivera St.",
            "address_2": "2nd floor Ste #2",
            "address_purpose": "LOCATION",
            "city": "Rincon",
            "state": "PR",
            "postal_code": "006771816",
            "country_code": "US",
            "telephone_number": "787-823-3363",
            "fax_number": "787-823-3363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ-MENDEZ",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.