Healthcare Provider Details

I. General information

NPI: 1871690776
Provider Name (Legal Business Name): GARRETT MICHAEL GUESS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR STE C113
LA JOLLA CA
92037-1703
US

IV. Provider business mailing address

8950 VILLA LA JOLLA DR STE C113
LA JOLLA CA
92037-1703
US

V. Phone/Fax

Practice location:
  • Phone: 858-558-0222
  • Fax: 858-558-0903
Mailing address:
  • Phone: 858-558-0222
  • Fax: 858-558-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number47724
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: