Active NPI
Ethel Jose Guerrero, DDS
- General Practice Dentistry
- Newark, CA
National Provider Identifier
1447281183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 48113
- Practice address
- 35436 Breton Dr
Newark, CA 94560-1709 - Phone
- (510) 304-4495
- Fax
- (510) 818-0503
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 48113 | CA | Primary |
Addresses
Primary practice location
35436 Breton Dr
Newark, CA 94560-1709
Mailing address
35436 Breton Dr
Newark, CA 94560-1709
Phone (510) 304-4495
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48113 | Other | CA | CA DENTAL LICENSE NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1447281183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35436 BRETON DR",
"city": "NEWARK",
"state": "CA",
"postal_code": "945601709",
"telephone_number": "510-304-4495",
"fax_number": "510-818-0503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35436 BRETON DR",
"city": "NEWARK",
"state": "CA",
"postal_code": "945601709",
"telephone_number": "510-304-4495",
"fax_number": "510-818-0503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRERO",
"first_name": "ETHEL",
"middle_name": "JOSE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48113",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA DENTAL LICENSE NUMBER",
"identifier": "48113",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.