Glenn Park DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052241 Issued in NY

Legal business name

GLENN PARK DDS PLLC

Practice address

7 Wells St
Suite #205
Saratoga Springs, NY 12866-1200

Phone

(515) 583-3205

Fax

(518) 583-3205

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Glenn ParkNPI 1083613715

Title

Owner

Phone

(518) 583-3205

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn Park, D.D.S.

  • General Practice Dentistry
  • Saratoga Springs, NY
  • NPI 1083613715
  NPD (past) Authorized official
• William Martin Sullivan, DDS

  • Dentist
  • Saratoga Springs, NY
  • NPI 1184776239
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023230133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WELLS ST",
            "address_2": "SUITE #205",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661200",
            "telephone_number": "515-583-3205",
            "fax_number": "518-583-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WELLS ST",
            "address_2": "SUITE #205",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661200",
            "telephone_number": "515-583-3205",
            "fax_number": "518-583-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN PARK DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-583-3205",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prajesh Mani Ghimire, M.D.
• E. Brooke Gifford, PA
• Scott Gillet, LCSW
• Rebecca Ann Gillingham, PMHNP
• Richard W Glaim
• Robert I Goguen
• Daniel Gold, PA
• John M Gold, MD
• Kelly Ann Goldenberg, CNM
• Polly Ellen Goldfarb

• General Practice Dentistry in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.