Healthcare Provider Details

I. General information

NPI: 1871383638
Provider Name (Legal Business Name): JENNIFER ANAHI GUTIERREZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20826 E RIGGS RD
QUEEN CREEK AZ
85142-7324
US

IV. Provider business mailing address

25611 S 201ST PL
QUEEN CREEK AZ
85142-7181
US

V. Phone/Fax

Practice location:
  • Phone: 623-900-4421
  • Fax:
Mailing address:
  • Phone: 480-621-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012621
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: