Gudella S. Licaros, DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

043676 Issued in NY

Legal business name

GUDELLA S. LICAROS, DDS

Practice address

155 W 68TH St
Suite 226
New York, NY 10023-5808

Phone

(212) 787-2749

NPI assigned

Sep 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gudella San Juan Licaros, DDS

Title

Dentist

Phone

(212) 787-2749

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1376737288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WEST 68TH STREET",
            "address_2": "SUITE 226",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235808",
            "telephone_number": "212-787-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W 68TH ST",
            "address_2": "SUITE 226",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235808",
            "telephone_number": "212-787-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUDELLA S. LICAROS, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "LICAROS",
        "authorized_official_first_name": "GUDELLA",
        "authorized_official_middle_name": "SAN JUAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "212-787-2749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "043676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayca Gucalp, M.D.
• Canan Kadriye Gucalp, MD
• Doru Gucer
• Patricia Guclu, AGPCNP-BC
• Kristin Gucwa, PT, DPT, CSCS
• Laura Guderian, M.D.
• Vamsi Krishna Gudey Venkata
• Kirana Gudi, MD
• Fernando Gudiel
• Leticia Gudiel

• Dental Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.