Individual provider Active NPI

Guillermo Manuel Aceves Jr., DDS

  • Dentist
  • Janesville, WI
National Provider Identifier
1447090766
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
600147615 Issued in WI
Practice address
2630 Liberty LN
Janesville, WI 53545-0717
Phone
(608) 752-2931
NPI assigned
May 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 600147615 WI Primary

Addresses

Primary practice location

2630 Liberty LN
Janesville, WI 53545-0717

Mailing address

5909 Sharpsburg Dr Apt 413
Madison, WI 53718-3048

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
600147615WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1447090766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 SHARPSBURG DR APT 413",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 LIBERTY LN",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450717",
            "telephone_number": "608-752-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVES",
        "first_name": "GUILLERMO",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "600147615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; 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.