Individual provider Active NPI

Norma D Gutierrez, DDS

  • Dentist
  • Manassas, VA
National Provider Identifier
1164730727
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412787 Issued in VA
Practice address
13489 Carapace CT
Manassas, VA 20112-3839
Phone
(703) 587-1293
NPI assigned
Sep 16, 2010
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412787 VA Primary

Addresses

Primary practice location

13489 Carapace CT
Manassas, VA 20112-3839

Mailing address

2712 Jefferson Davis Hwy
Suite 201
Stafford, VA 22554-1769
Phone (540) 720-8630

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
0401412787VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Aquia Dental Care Past Accepting new patients
Norma Gutierrez DDS PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1164730727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 201",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541769",
            "telephone_number": "540-720-8630",
            "fax_number": "540-720-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13489 CARAPACE CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123839",
            "telephone_number": "703-587-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "NORMA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.