Individual provider · Type 1 NPI

Jessica Gonzalez

Pediatric Dentistry · Hialeah, FL

NPI number 1205406360 Active

Practice location

4410 W 16th Ave Ste 52
Hialeah, FL 33012-7193

Mailing address

609 SW 5th Ave
Fort Lauderdale, FL 33315-1023

Specialties and licenses

TaxonomyCodeLicense
Pediatric Dentistry 1223P0221X22DI02980200 (NJ)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Pediatric Dentistry Primary 1223P0221XDN26610 (FL)

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

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About NPI 1205406360

Jessica Gonzalez's National Provider Identifier is 1205406360, issued on Jun 30, 2021. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Hialeah, FL. The record was last updated on Jun 16, 2025.