Active NPI
Daniel Gutierrez Solis
- Dental Assistant
- Riverside, CA
National Provider Identifier
1093240665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 77894
- Practice address
- 5355 Kent Ave
Riverside, CA 92503-2428 - Phone
- (951) 675-8020
- NPI assigned
- Apr 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 77894 | CA | Primary |
Addresses
Primary practice location
5355 Kent Ave
Riverside, CA 92503-2428
Mailing address
5355 Kent Ave
Riverside, CA 92503-2428
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77894 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77894 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1093240665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5355 KENT AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925032428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5355 KENT AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925032428",
"telephone_number": "951-675-8020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ SOLIS",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-20",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "77894",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77894",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.