Healthcare Provider Details

I. General information

NPI: 1083565634
Provider Name (Legal Business Name): JOVANI M. GONZALEZ, D.D.S., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 S DIXIE HWY
WEST PALM BEACH FL
33405-4602
US

IV. Provider business mailing address

6809 S DIXIE HWY
WEST PALM BEACH FL
33405-4602
US

V. Phone/Fax

Practice location:
  • Phone: 561-585-2006
  • Fax: 561-585-2018
Mailing address:
  • Phone: 954-394-8176
  • Fax: 561-585-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. JOVANI MIGUEL GONZALEZ
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 954-394-8176