Timothy L Gutierrez Sr., DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1556 Issued in NM

Practice address

1513 Carlisle Blvd NE
Albuquerque, NM 87110

Phone

(505) 881-7373

Fax

(505) 881-5096

NPI assigned

Oct 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 17, 2012 through Aug 17, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tgutierrez32879@ahs.direct-ci.com

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.

• Timothy L Gutierrez DMD PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Albuquerque, NM
  • NPI 1013070911
  NPD (past) Authorized official
• Ryan Sterk Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Albuquerque, NM
  • NPI 1891365052
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275613788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 CARLISLE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-881-7373",
            "fax_number": "505-881-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 CARLISLE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-881-7373",
            "fax_number": "505-881-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "1556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88906",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roselle Julie Gutierrez, NP
• Samantha Gutierrez
• Sandra P Gutierrez, DNP
• Shanna Dominica Gutierrez, LTC HOME CARE, LLC
• Theresa A Gutierrez, CFNP
• Vanessa Gutierrez
• Christopher James Gutjahr, MD
• Bryan Courtland Gutman, MD
• Julie Anne Gutmann, LMT
• Stefan H. Gutow, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Mexico

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.