Jeremy Gutovitz, DDM

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2023022617 Issued in MO

Practice address

205 E Dakota St
Butler, MO 64730-2113

Phone

(844) 853-8937

NPI assigned

May 3, 2023

Last updated

Jun 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Compass Health, Inc

  dba Compass Health Network

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  Medicare reassignment NPD
• Compass Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1558258632
  NPD

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1144919465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E DAKOTA ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647302113",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOVITZ",
        "first_name": "JEREMY",
        "credential": "DDM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2023022617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Gaines, PTA
• Michael J Gardner, PHD
• Chastity Gillen, 2014044014
• Alissa Goertz
• Meagan Ashley Guerreiro, LPC
• Lydia Marie Haas, RDH
• Lacee Hair
• Linda Lou Ann Hallam, RN
• Healthcare Center of Functional Medicine, LLC
• Heartland Hospice Services LLC (Heartland Hospice Services)

• General Practice Dentistry in Butler, MO
• Providers in Butler, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.