Individual provider Active NPI

Kelly Guthrie, D.M.D.

  • General Practice Dentistry
  • Fort Lauderdale, FL
National Provider Identifier
1639579626
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AL4787 Issued in AL
Practice address
16443 Segovia Cir S
Fort Lauderdale, FL 33331-4622
Phone
(954) 347-2308
NPI assigned
Aug 27, 2014
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20052 FL
General Practice Dentistry 1223G0001X AL4787 AL Primary

Addresses

Primary practice location

16443 Segovia Cir S
Fort Lauderdale, FL 33331-4622

Mailing address

16443 Segovia Cir S
Fort Lauderdale, FL 33331-4622
Phone (954) 347-2308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20170220002343 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345523213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AL4787ALMDGeneral Practice Dentistry
DN20052FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1639579626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16443 SEGOVIA CIR S",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333314622",
            "telephone_number": "954-347-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16443 SEGOVIA CIR S",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333314622",
            "telephone_number": "954-347-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20052",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL4787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.