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DR. THERESA SULLIVAN GONZALES DMD, MS
NPI 1912969502
Dentist - Oral and Maxillofacial Pathology in Charleston, SC

Active since April 06, 2006PECOS Enrolled
173 ASHLEY AVENUE MSC 507, CHARLESTON, SC 29401(843) 792-8723(843) 792-3697 Get Directions Write a Review

NPPES record last updated: August 31, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Theresa Sullivan Gonzales Dmd, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THERESA SULLIVAN GONZALES DMD, MS (NPI 1912969502) is an individual oral and maxillofacial pathology provider in Charleston, South Carolina, licensed in South Carolina (2648) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912969502
Entity TypeIndividualFemale
Primary Taxonomy1223P0106X
Provider Legal NameDR. THERESA SULLIVAN GONZALESCredential: DMD, MS
Location Address173 ASHLEY AVENUE MSC 507Charleston, SC 29401
Mailing AddressPo Box 751461Charlotte, NC 28275-1461 · (843) 792-6200
Phone(843) 792-8723
Fax(843) 792-3697
Sole ProprietorNo
Enumeration DateApril 6, 2006
Last NPPES UpdateAugust 31, 2016
✔ NPI 1912969502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers
Taxonomy Code1223P0106X
Licenses✔ Licensed in SC · 2648✔ Licensed in TX · 17566
Definition
The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.
173 ASHLEY AVENUE MSC 507, Charleston, SC 29401
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Theresa Sullivan Gonzales Dmd, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Gonzales's NPI number?

The NPI number for Theresa Gonzales is 1912969502. It was assigned to this individual provider in the NPPES registry on April 6, 2006.

Where is Theresa Gonzales located?

Theresa Gonzales practices at 173 Ashley Avenue Msc 507, Charleston, SC 29401. The listed phone number is (843) 792-8723.

What is Theresa Gonzales's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Pathology, with taxonomy code 1223P0106X.

Is Theresa Gonzales enrolled in Medicare?

Yes. Theresa Gonzales is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Theresa Gonzales was last updated on August 31, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.