Guadalupe Gutierrez II, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D4664 Issued in ID

Practice address

2615 N Fruitland LN
Coeur D Alene, ID 83815-7914

Phone

(208) 765-3301

NPI assigned

Aug 27, 2015

Last updated

Aug 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 17, 2022 through May 17, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Day 1 Dental, PLLC

  dba Day 1 Dental

  • Dental Clinic/Center
  • Las Vegas, NV
  • NPI 1033925243
  NPD Authorized official
• Loftus Family Dental

  • Point of Service
  • Coeur d'Alene, ID
  • NPI 1740661388
  Authorized official Same address or phone
• Parkway Dental Group PLLC

  • General Practice Dentistry
  • St George, UT
  • NPI 1942618590
  NPD (past)

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1730556515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9530 S EASTERN AVE STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891238036",
            "telephone_number": "725-331-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 N FRUITLAND LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157914",
            "telephone_number": "208-765-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "GUADALUPE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7888",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guiding Light Counseling
• Hannah Rose Gumaer
• Kendall Ann Gunderson, FNP
• Sandra Marie Gunn, LMFT
• Leonard D Guth, M.D.
• Rebecca Haddad, PA-C
• Robert W Hagen, MD
• Ryan Hale
• Haley Vision Center, PLLC
• Chad Halford, PT, DPT

• Dentist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.