Individual provider Active NPI

Michelle Dayanne Gutierrez Resto

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1144801945
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
062863 Issued in NY
Practice address
169 Wyckoff Ave
Brooklyn, NY 11237-4303
Phone
(646) 393-5454
NPI assigned
Apr 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 062863 NY Primary

Addresses

Primary practice location

169 Wyckoff Ave
Brooklyn, NY 11237-4303

Mailing address

1573 3Rd Ave Apt 4B
New York, NY 10128-2717

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

LicenseStateTypeSpecialty
062863NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Dental Arts, PC General Practice PastSince Apr 20, 2025 Accepting new patients

Organizations & group practices 1

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1144801945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 3RD AVE APT 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 WYCKOFF AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374303",
            "telephone_number": "646-393-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ RESTO",
        "first_name": "MICHELLE",
        "middle_name": "DAYANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.