Active NPI
Mauricio Gutierrez, D.M.D.
- Periodontics
- West Palm Beach, FL
National Provider Identifier
1699053496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN15167
- Practice address
- 1515 N Flagler Dr
Suite 301
West Palm Beach, FL 33401-3428 - Phone
- (561) 655-1700
- Fax
- (561) 853-0793
- NPI assigned
- Jul 27, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN15167 | FL | Primary |
Addresses
Primary practice location
1515 N Flagler Dr
Suite 301
West Palm Beach, FL 33401-3428
Mailing address
1515 N Flagler Dr
Suite 301
West Palm Beach, FL 33401-3428
Phone (561) 655-1700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2025 through Jan 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN15167 | FL | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Institute for Periodontics & Dental Implants, P.a. | Periodontics | Past | Accepting new patients |
| Florida Institute for Periodontics & Dental Implants, P.a. | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Periodontics
- Wellington, FL
- NPI 1316225121
-
- Periodontics
- West Palm Beach, FL
- NPI 1831477629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311724800000",
"number": "1699053496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 N FLAGLER DR",
"address_2": "SUITE 301",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334013428",
"telephone_number": "561-655-1700",
"fax_number": "561-853-0793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 N FLAGLER DR",
"address_2": "SUITE 301",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334013428",
"telephone_number": "561-655-1700",
"fax_number": "561-853-0793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "MAURICIO",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-27",
"last_updated": "2011-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN15167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.