Provider Demographics
NPI:1316700693
Name:GONZALEZ, JANELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HIGH ST APT 671
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-1132
Mailing Address - Country:US
Mailing Address - Phone:305-509-9034
Mailing Address - Fax:
Practice Address - Street 1:2937 COBB PKWY SE STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3519
Practice Address - Country:US
Practice Address - Phone:770-240-0328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1237791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice