Individual provider Active NPI

Vincent Michael Guido, DDS

  • General Practice Dentistry
  • Lafayette, IN
National Provider Identifier
1225047103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008212 Issued in IN
Practice address
150 Professional CT.
Suite B
Lafayette, IN 47905-5153
Phone
(765) 448-4242
NPI assigned
Aug 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 12008212 IN Primary

Addresses

Primary practice location

150 Professional CT.
Suite B
Lafayette, IN 47905-5153

Mailing address

150 Professional Court
Lafayette, IN 47905-5153
Phone (765) 448-4242

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
I20150401000027 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7810214871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008212INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vibrant Dental LLC General Practice PastSince Dec 21, 2021 Accepting new patients
Guido Family Dentistry General Practice 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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225047103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PROFESSIONAL COURT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055153",
            "telephone_number": "765-448-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PROFESSIONAL CT.",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055153",
            "telephone_number": "765-448-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDO",
        "first_name": "VINCENT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.