Individual provider Active NPI

Gary A Glaviano, DDS

  • General Practice Dentistry
  • Metairie, LA
National Provider Identifier
1023154580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2714 Issued in LA
Practice address
4400 Trenton Street
Suite J
Metairie, LA 70006-6550
Phone
(504) 885-9599
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2714 LA Primary

Addresses

Primary practice location

4400 Trenton Street
Suite J
Metairie, LA 70006-6550

Mailing address

4400 Trenton Street
Suite J
Metairie, LA 70006-6550
Phone (504) 885-9599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202000963 LA Order and Referring Only - DentistPractitioner - Dentist 8022318708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2714LAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Metairie Dental Loft PastSince Feb 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023154580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 TRENTON STREET",
            "address_2": "SUITE J",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700066550",
            "telephone_number": "504-885-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 TRENTON STREET",
            "address_2": "SUITE J",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700066550",
            "telephone_number": "504-885-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVIANO",
        "first_name": "GARY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.