1356342174 NPI number — CATHERINE DIANE GUERRA DDS

Table of content: CATHERINE DIANE GUERRA DDS (NPI 1356342174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356342174 NPI number — CATHERINE DIANE GUERRA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUERRA
Provider First Name:
CATHERINE
Provider Middle Name:
DIANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356342174
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1359 INTERQUEST PARKWAY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80921-8333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-360-2403
Provider Business Mailing Address Fax Number:
719-632-6283

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1359 INTERQUEST PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80921-8333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-374-5496
Provider Business Practice Location Address Fax Number:
719-900-7795
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  7212 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: DEN.00007212 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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