Provider Demographics
NPI:1932649571
Name:GUEDES FILHO, JOSE EDIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:EDIR
Last Name:GUEDES FILHO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19406 STONY POINT DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-8160
Mailing Address - Country:US
Mailing Address - Phone:216-302-5140
Mailing Address - Fax:
Practice Address - Street 1:185 TREWIN CIR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3542
Practice Address - Country:US
Practice Address - Phone:216-302-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN27744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program