NPIMap

Individual provider Active NPI

Sonia Gutierrez, D.D.S., M.S

  • Pediatric Dentistry
  • Grayslake, IL
National Provider Identifier
1730365644
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Practice address
160 Commerce Dr
Suite 100
Grayslake, IL 60030-1601
Phone
(847) 223-1400
Fax
(847) 223-1478
NPI assigned
Jan 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X IL Primary

Addresses

Primary practice location

160 Commerce Dr
Suite 100
Grayslake, IL 60030-1601

Mailing address

160 Commerce Dr
Suite 100
Grayslake, IL 60030-1601
Phone (847) 223-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019-022562ILMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Dentist, PC Pediatric Dentistry Past Accepting new patients
Manjote K Dhaliwal DDS PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1730365644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 COMMERCE DR",
            "address_2": "SUITE 100",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301601",
            "telephone_number": "847-223-1400",
            "fax_number": "847-223-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 COMMERCE DR",
            "address_2": "SUITE 100",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301601",
            "telephone_number": "847-223-1400",
            "fax_number": "847-223-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "SONIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.