Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. Jose Antonio Gonzalez , DDS

Dentist - General Practice β€’ Oconomowoc, WI

Active NPI 1508430091 Individual Practitioner Male Practitioner
Practice location in NPPES

888 Thackeray Trl Ste 214
Oconomowoc, WI 530664342

Call 2625679116 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

888 Thackeray Trl Ste 214

Oconomowoc, WI 530664342

Telephone 2625679116
Fax 2625675870
Organization at the Same NPPES Address or Phone
Oconomowoc Dental Anesthesia Center Facility NPI 1053972661

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Gonzalez has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Gonzalez as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Oconomowoc and Wisconsin

13 active clinicians are listed under Dentist - General Practice with a practice address in Oconomowoc, WI (2,305 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Oconomowoc

0% of these 13 clinicians have the CMS telehealth indicator.

0% of these 13 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-09-18
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES WI 1002705

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DENTIST

Medicare Enrollment ID

I20250630000502

Enrollment State Jurisdiction

MN

PECOS Control ID

0840703203

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location September 18, 2024

Registered at 888 THACKERAY TRL STE 214, OCONOMOWOC, WI 530664342 (Tel: 2625679116)

πŸ“
Updated Business Mailing Address September 18, 2024

Registered at 5646 S 45TH ST, GREENFIELD, WI 532205209

πŸ‘€
Provider Name / Credentials Updated September 18, 2024

Recorded as JOSE GONZALEZ, DDS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 02, 2022

Dentist (license number reported to NPPES: WI 1002705)

βœ…
NPI Profile Active May 18, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 18, 2021

Registered at 1801 W WISCONSIN AVE, MILWAUKEE, WI 532332186 (Tel: 4142886790)

πŸ“
Business Mailing Address (Initial Record) May 18, 2021

Registered at 1801 W WISCONSIN AVE, MILWAUKEE, WI 532332186

πŸ‘€
Provider Name / Credentials (Initial Record) May 18, 2021

Recorded as JOSE GONZALEZ

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2021

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration May 18, 2021

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1508430091
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 18, 2021
Last Update: September 18, 2024
Sole Proprietor: No

Other Dentist - General Practices in Oconomowoc

All Dentist - General Practices in Oconomowoc

Mailing Address

5646 S 45th St

Greenfield, WI 532205209

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.