Individual provider Active NPI

Edy Augusto Guerra, DDS

  • General Practice Dentistry
  • Coral Gables, FL
National Provider Identifier
1174749691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN13559 Issued in FL
Practice address
4011 W Flagler St
Suite 506
Coral Gables, FL 33134-1643
Phone
(305) 643-1444
Fax
(305) 643-0447
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN13559 FL Primary

Addresses

Primary practice location

4011 W Flagler St
Suite 506
Coral Gables, FL 33134-1643

Mailing address

145 Deer Run
Miami Springs, FL 33166-5787
Phone (305) 643-1444

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
DN13559FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174749691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 DEER RUN",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331665787",
            "telephone_number": "305-643-1444",
            "fax_number": "305-643-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 W FLAGLER ST",
            "address_2": "SUITE 506",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331341643",
            "telephone_number": "305-643-1444",
            "fax_number": "305-643-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "EDY",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.