MEDICARE: DR. JANET STONE GONZALEZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16710	TX

General Provider Information

NPI Number	:	1164445987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET STONE GONZALEZ DDS

Provider Business Mailing Address
First Line	:	18564 VISTA DEL SOL
Second Line	:	STE 240
City	:	DALLAS
State	:	TX
Zip	:	75287-4019
Country	:	US
Telephone Number	:	972-742-5798
Fax Number	:

Provider Business Practice Location Address
First Line	:	546 E SANDY LAKE RD
Second Line	:	STE 240
City	:	COPPELL
State	:	TX
Zip	:	75019-5786
Country	:	US
Telephone Number	:	972-304-0489
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	05/27/2016

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