# DR. JEREL D GUTIERREZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598891509
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401411448 | VA | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 01/24/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11448 | DELTA | VA |
| 01 | — | 1865742 | UNITED CONCORDIA | — |
| 01 | — | 238989 | ANTEM BC & BS OF VA | VA |