Jesse Guzman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60169661 Issued in WA

Practice address

1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642

Phone

(360) 676-6177

Fax

(360) 671-3574

NPI assigned

Jul 26, 2006

Last updated

Mar 19, 2019By 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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1972526002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 TREE FARM CT",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982261759",
            "telephone_number": "208-631-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "591 E State St",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836165938",
            "country_code": "US",
            "telephone_number": "208-939-0918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3934",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60169661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry N. Gustafson, LMP, ATC, AT/L
• Kendal Alexis Gutierrez, RD
• Mary Gutierrez, MSW, LICSW
• Susan Guttzeit, LMP
• Diana Guza-Wells, M.D.
• Catherine Gwaltney, DC
• Tung Mai Ha, DO
• Kayla Anne Elaun Hackman
• Janet Marina Hadfield, LPN
• Laura Lee Hadwiger, R.PH.

• Dentist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.