NPIMap

Organization Active NPI

Marcella Guzman DDS PC

  • Dentist
  • Chicago, IL
National Provider Identifier
1669734406
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019023702 Issued in IL
Legal business name
MARCELLA GUZMAN DDS PC
Practice address
3236 W Fullerton Ave
Chicago, IL 60647-2512
Phone
(773) 276-0300
Fax
(773) 252-5994
NPI assigned
Jun 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Authorized official

Name
Marcella R Guzman, DDSNPI 1245396126
Title
Dentist
Phone
(773) 276-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019023702 IL Primary

Addresses

Primary practice location

3236 W Fullerton Ave
Chicago, IL 60647-2512

Mailing address

3236 W Fullerton Ave
Chicago, IL 60647-2512
Phone (773) 276-0300

Other names 1

  • A Brush Above Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
A Brush Above2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3236 W Fullerton Ave
Chicago, IL 60647
Phone (773) 276-0300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1669734406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472512",
            "telephone_number": "773-276-0300",
            "fax_number": "773-252-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472512",
            "telephone_number": "773-276-0300",
            "fax_number": "773-252-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCELLA GUZMAN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-276-0300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Brush Above Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.