Provider Demographics
NPI:1780608349
Name:RICARDO GONZALEZ DDS LTD
Entity type:Organization
Organization Name:RICARDO GONZALEZ DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:RICARDO
Authorized Official - Last Name:GONZALEZ-JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-898-3610
Mailing Address - Street 1:1780 N FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1576
Mailing Address - Country:US
Mailing Address - Phone:630-898-3610
Mailing Address - Fax:630-898-6362
Practice Address - Street 1:1780 N FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1576
Practice Address - Country:US
Practice Address - Phone:630-898-3610
Practice Address - Fax:630-898-6362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
IL019-0184571223P0221X, 1223G0001X
IL021-0012461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty