Louis E Guillory, D.D.S.
Individual provider Active NPI Dentist · Lakewood, CO
NPI 1003137282 · NPPES record last updated Feb 25, 2025
Key facts
- NPI
- 1003137282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 203186 (CO)
- Practice address
- 5392 S Wadsworth Blvd Unit 103
Lakewood, CO 80123-1271 - Phone
- (303) 979-4277
- NPI assigned
- Jun 22, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 203186 | CO | MD | Dentist |
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Firestone Dental Care, LLC | Dentist | Past | Accepting new patients |
Networks
- NM HMO C-SNP
- CO HMO D-SNP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 055792 | NY | |
| Dentist | 122300000X | 203186 | CO | Yes |
Addresses
Primary practice location
5392 S Wadsworth Blvd Unit 103
Lakewood, CO 80123-1271
Mailing address
PO Box 860036
Minneapolis, MN 55486-0036
Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.