Sergio Ivan Guzman, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22644 Issued in TX

Practice address

1317 St Claire Blvd Ste A3
Mission, TX 78572-6636

Phone

(956) 581-4403

Fax

(956) 581-2242

NPI assigned

Jul 25, 2007

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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Guzman Pediatric Dentistry

  • Pediatric Dentistry
  • Mission, TX
  • NPI 1609049527
  NPD (past) Authorized official
• Little Heroes Pediatric Denitstry PLLC

  • Pediatric Dentistry
  • Laredo, TX
  • NPI 1548506355
  NPD (past) Authorized official

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220659200000",
    "number": "1497945679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ST CLAIRE BLVD STE A3",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726636",
            "telephone_number": "956-581-4403",
            "fax_number": "956-581-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 ST CLAIRE BLVD STE A3",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726636",
            "telephone_number": "956-581-4403",
            "fax_number": "956-581-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "SERGIO",
        "middle_name": "IVAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2008-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "22644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186204704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSBDE",
            "identifier": "22644",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186204705",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIPS",
            "identifier": "B22644-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "K0152252",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Gutierrez
• Yadhira Gutierrez
• Guzman Pediatric Dentistry
• Alicia Guzman, FNP
• Elizabeth Guzman, NP
• Yesenia Ruby Guzman, BSN, RN
• H & H Quality Construction LLC
• H V Primary Home Care, Inc.
• H-E-B, LP
• H-E-B, LP

• Pediatric Dentistry in Mission, TX
• Providers in Mission, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2008; 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.