Healthcare Provider Details

I. General information

NPI: 1144197880
Provider Name (Legal Business Name): GUILHERME GAYER MADUREIRA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2025
Last Update Date: 10/24/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 PISGAH CHURCH RD
GREENSBORO NC
27455-3308
US

IV. Provider business mailing address

501 W 4TH ST APT 334
WINSTON SALEM NC
27101-3861
US

V. Phone/Fax

Practice location:
  • Phone: 336-271-7900
  • Fax:
Mailing address:
  • Phone: 445-448-5248
  • Fax: 445-448-5248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0302
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: