National Provider Identifier Database

ASIAH J GONZALEZ, LDT – NPI #1194316075
Dental Therapist

A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations.


Contact Information

ASIAH J GONZALEZ, LDT
17395 RESERVATION RD
LA CONNER, WA98257-8802
Phone: 360-466-3900
Fax:
Website:
Specialty Taxonomy Code
* Dental Therapist 125J00000X

* Indicates primary specialty

NPI Profile & details for ASIAH J GONZALEZ

NPI Number 1194316075
Credentials LDT
Entity Individual
Enumeration date 02/02/2021
Last updated 02/02/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • WA License #: 19-TDT-02
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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