Laura Guevara, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4825015 Issued in WI

Practice address

519 Christel Drive
Valders, WI 54245

Phone

(920) 775-4531

Fax

(920) 775-4180

NPI assigned

Sep 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in WI

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valders Dental Associates SC

  • General Practice Dentistry
  • Valders, WI
  • NPI 1659487825
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679674477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 CHRISTEL DRIVE",
            "city": "VALDERS",
            "state": "WI",
            "postal_code": "54245",
            "telephone_number": "920-775-4531",
            "fax_number": "920-775-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 CHRISTEL DRIVE",
            "city": "VALDERS",
            "state": "WI",
            "postal_code": "54245",
            "telephone_number": "920-775-4531",
            "fax_number": "920-775-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4825015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4825015",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33742000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A&J Vans Inc
• Aurora Medical Group, Inc.
• Ann Marie Barry
• Nicole E Check, M.S. CFY-SLP
• Victoria Claybrook, BSN, RN
• Jennifer L Ladwig, NP
• Natash Ana Notz, RN
• Samantha Sue Pate
• Thomas Peirick, DDS
• Alex Pekarske

• General Practice Dentistry in Valders, WI
• Providers in Valders, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.