Luisa Fernanda Gongora, DDS is a
Dentist based in Needles, California. Luisa Fernanda Gongora is licensed to practice in California (license number 111127) and her current practice location is
820 W Broadway St, Needles, California. She can be reached at her office (for appointments etc.) via phone at
(844) 444-1424.
NPI number for Luisa Fernanda Gongora is 1679383384 and her current mailing address is 6517 Old Oxford Ave, Las Vegas, Nevada. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1679383384.
Healthcare Provider's Profile
Full Name | Luisa Fernanda Gongora |
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Gender | Female |
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Speciality | Dentist |
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Location | 820 W Broadway St, Needles, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1679383384
- Provider Enumeration Date: 01/14/2025
- Last Update Date: 01/14/2025
Medical Identifiers
Medical identifiers for Luisa Fernanda Gongora such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679383384 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 111127 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Luisa Fernanda Gongora is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Luisa Fernanda Gongora, DDS 6517 Old Oxford Ave, Las Vegas, NV 89108-0201 Ph: (617) 461-2485 | Luisa Fernanda Gongora, DDS 820 W Broadway St, Needles, CA 92363-2729 Ph: (844) 444-1424 |
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