Provider Demographics
NPI:1558867317
Name:GUTIERREZ, ZOEY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ZOEY
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 TURTLE COVE LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2323
Mailing Address - Country:US
Mailing Address - Phone:772-913-1825
Mailing Address - Fax:
Practice Address - Street 1:373 SEBASTIAN BLVD
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-4550
Practice Address - Country:US
Practice Address - Phone:772-913-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1023571223G0001X
FLDN247571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice