Individual provider Active NPI

Elena Gutu, DMD

  • General Practice Dentistry
  • St Petersburg, FL
National Provider Identifier
1023109493
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17133 Issued in FL
Practice address
5500 1St Ave N
St Petersburg, FL 33710-8006
Phone
(727) 954-4431
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17133 FL Primary

Addresses

Primary practice location

5500 1St Ave N
St Petersburg, FL 33710-8006

Mailing address

5500 1St Ave N
St Petersburg, FL 33710-8006
Phone (727) 954-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317000386 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880911650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1023109493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108006",
            "telephone_number": "727-954-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108006",
            "telephone_number": "727-954-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTU",
        "first_name": "ELENA",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.