Individual provider Active NPI

Mayra Gutierrez, DDS

  • Dentist
  • Bakersfield, CA
National Provider Identifier
1700278041
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109890 Issued in CA
Practice address
1014 Calloway Dr
Bakersfield, CA 93312-6337
Phone
(866) 707-6664
NPI assigned
Feb 24, 2015
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109890 CA Primary

Addresses

Primary practice location

1014 Calloway Dr
Bakersfield, CA 93312-6337

Mailing address

9913 San Diego St
Lamont, CA 93241-1221
Phone (661) 378-2896

Other practice location 1

3800 Mall View Rd
Bakersfield, CA 93306-3029
Phone (866) 707-6664

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250916003143 CA Practitioner - Dentist 8527562388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Herman Ostrow School of Dentistry of Usc, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4900 California Ave
400B
Bakersfield, CA 93309-7081

4900 California Ave
Suite 400B
Bakersfield, CA 93309-7004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109890CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Family Health CurrentSince Sep 3, 2025 Accepting new patients
Omni Family Health Current Accepting new patients
Omni Family Health CurrentSince Sep 3, 2025 Accepting new patients
Encompass Community Services Past Accepting new patients
Veterans Administration PastSince Apr 1, 2024 Accepting new patients

Locations

1014 Calloway Dr
Bldg F
Bakersfield, CA 93312

3800 Mall View Rd
Bakersfield, CA 93306

4151 Mexicali Dr
Bakersfield, CA 93313

4900 California Ave
Ste 400B
Bakersfield, CA 93309
Phone (661) 630-7046

525 Roberts Ln
Bakersfield, CA 93308
Phone (661) 392-7850

6700 Niles St
Ste 185
Bakersfield, CA 93306

277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381

355 Campus Dr
Ste E
Hanford, CA 93230
Phone (559) 584-0668

925 G St
Reedley, CA 93654
Phone (559) 558-9712

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1700278041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9913 SAN DIEGO ST",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411221",
            "telephone_number": "661-378-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 CALLOWAY DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933126337",
            "telephone_number": "866-707-6664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Mall View Rd",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933063029",
            "country_code": "US",
            "telephone_number": "866-707-6664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MAYRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.