Eduard M. Gutgarts, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28564 Issued in CA

Practice address

1510 N Poinsettia PL
Los Angeles, CA 90046-3611

Phone

(323) 851-7140

Fax

(323) 851-6117

NPI assigned

Mar 5, 2007

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 CA

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

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689703407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N POINSETTIA PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900463611",
            "telephone_number": "323-851-7140",
            "fax_number": "323-851-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N POINSETTIA PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900463611",
            "telephone_number": "323-851-7140",
            "fax_number": "323-851-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTGARTS",
        "first_name": "EDUARD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gustavo a Alza MD a Medical Corporation
• Mary Jo Gustin, D.C.
• Sarah N Gustin, RD
• Kimberly Ann Gustovich, M.A., CCC-A
• Shelly Anne Gutensohn, LMFT
• Diana S Guth, RRT
• Eve S. Guth, MD
• Kevin Brant Guthmiller, M.D.
• Monica R Guthrie
• Taylor L. Guthrie, LCSW

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• 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.