Individual provider Active NPI

Patrick Michael Glisczinski, DDS

  • General Practice Dentistry
  • Brentwood, TN
National Provider Identifier
1093330342
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11280 Issued in TN
Practice address
330 Franklin Rd Ste 230B
Brentwood, TN 37027-3210
Phone
(615) 661-7866
NPI assigned
Jun 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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 11280 TN Primary

Addresses

Primary practice location

330 Franklin Rd Ste 230B
Brentwood, TN 37027-3210

Mailing address

330 Franklin Rd Ste 230B
Brentwood, TN 37027-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11280TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Sleep Solutions LLC PastSince Jun 14, 2020 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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1093330342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 FRANKLIN RD STE 230B",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 FRANKLIN RD STE 230B",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273210",
            "telephone_number": "615-661-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLISCZINSKI",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.