Individual provider Active NPI

Arby Alcantara Gutierrez, D.D.S.

  • General Practice Dentistry
  • Long Beach, CA
National Provider Identifier
1366560849
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54990 Issued in CA
Practice address
1171 E Bixby Rd
Long Beach, CA 90807-4125
Phone
(562) 595-9131
Fax
(562) 989-6864
NPI assigned
Mar 26, 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 54990 CA Primary

Addresses

Primary practice location

1171 E Bixby Rd
Long Beach, CA 90807-4125

Mailing address

2419 Daisy Ave
Long Beach, CA 90806-2918
Phone (562) 715-5563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160705001910 CA Order and Referring Only - DentistPractitioner - Dentist 5395037709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54990CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen E. Adams, DDS, Inc. General Practice Past Accepting new patients
Arby Gutierrez DDS Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366560849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 DAISY AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062918",
            "telephone_number": "562-715-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 E BIXBY RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074125",
            "telephone_number": "562-595-9131",
            "fax_number": "562-989-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ARBY",
        "middle_name": "ALCANTARA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.