Paul Martin Gutierrez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7966 Issued in NV

Practice address

366 W Lake Mead Pkwy Ste 100
Henderson, NV 89015-7287

Phone

(702) 464-3090

NPI assigned

Aug 23, 2021

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1528734159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 W LAKE MEAD PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157287",
            "telephone_number": "915-799-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 W LAKE MEAD PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157287",
            "telephone_number": "702-464-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "PAUL",
        "middle_name": "MARTIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-23",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Amanda Gutierrez, MD, MPH
• Jaclyn M Gutierrez, COTA/L
• Jake Gutierrez
• Manuel Fernando Gutierrez Jr., MD
• Maricela Gutierrez
• Kathleen A Gutzat, OTR/L
• Tatiana Guyton
• Alfonsa Guzman-Guzman
• Mario Guzman, BA
• Mary Guzman

• General Practice Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.