Active NPI
Luis Antonio Gonzalez, D.M.D, M.D.
- Oral and Maxillofacial Surgery (Dentist)
- Birmingham, AL
National Provider Identifier
1982673513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 14669
- Practice address
- 101 Heatherbrooke Park Dr
Birmingham, AL 35242-8008 - Phone
- (205) 991-9787
- Fax
- (205) 991-2687
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 14669 | AL | Primary |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 3935 | AL |
Addresses
Primary practice location
101 Heatherbrooke Park Dr
Birmingham, AL 35242-8008
Mailing address
4029 Greystone Dr
Birmingham, AL 35242-6406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170620001667 | AL | Order and Referring Only - Maxillofacial Surgery | 7618245499 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3935 | AL | MD | Professional Counselor |
| 14669 | AL | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniscalco Oral and Facial Surgery LLC | Past | Accepting new patients | |
| Gonzalez & Carr, P.C. | Oral and Maxillofacial Surgery | Past | Accepting new patients |
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Birmingham, AL
- NPI 1740469311
-
- Oral and Maxillofacial Surgery Clinic/Center
- Birmingham, AL
- NPI 1376271056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1982673513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4029 GREYSTONE DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352426406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HEATHERBROOKE PARK DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352428008",
"telephone_number": "205-991-9787",
"fax_number": "205-991-2687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "LUIS",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "D.M.D, M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "AL",
"license": "14669",
"primary": true
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "AL",
"license": "3935",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.