Individual provider Active NPI

Tracy Marie Guilford, D.D.S.

  • General Practice Dentistry
  • New Albany, IN
National Provider Identifier
1124240411
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011238A Issued in IN
Practice address
5104 Charlestown Rd.
New Albany, IN 47150
Phone
(812) 941-1400
Fax
(812) 941-8089
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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 12011238A IN Primary

Addresses

Primary practice location

5104 Charlestown Rd.
New Albany, IN 47150

Mailing address

5104 Charlestown Rd.
New Albany, IN 47150
Phone (812) 941-1400

Other names 1

  • Tracy Marie Walsh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170817002244 IN Practitioner - Oral Surgery 8325369440 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crossings Clinic LLC CurrentSince Jun 20, 2017 Accepting new patients
Louisville Dental Sleep Medicine PLLC PastSince Jun 21, 2017 Accepting new patients
Crossings Clinic LLC PastSince Aug 11, 2019 Accepting new patients

Locations

5520 E Highway 62
Jeffersonvlle, IN 47130
Phone (812) 280-8000

5104 Charlestown Rd
New Albany, IN 47150
Phone (812) 670-5907

5140 Charlestown Rd
New Albany, IN 47150
Phone (812) 941-9000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1124240411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 CHARLESTOWN RD.",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "47150",
            "telephone_number": "812-941-1400",
            "fax_number": "812-941-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5104 CHARLESTOWN RD.",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "47150",
            "telephone_number": "812-941-1400",
            "fax_number": "812-941-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILFORD",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011238A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "WALSH",
            "middle_name": "MARIE",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.