Glenn George Thomason, D.D.S.
Individual provider Active NPI Dentist · Tierra Amarilla, NM
NPI 1093798985 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1093798985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DD-2075 (NM)
- Practice address
- U.S. Hwy 84 N, CR 324, #14
Tierra Amarilla, NM 87576 - Phone
- (505) 588-7289
- NPI assigned
- Nov 23, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9837 | TX | MD | Chiropractor |
| DD-2075 | NM | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD-2075 | NM | Yes |
Addresses
Primary practice location
U.S. Hwy 84 N, CR 324, #14
Tierra Amarilla, NM 87576
Mailing address
PO Box 616
Chama, NM 87520-0616
Phone (505) 756-2345
Other providers in Tierra Amarilla, NM
- Caitlin Mercure
- Philip Onyirimba
- Carole L Owens
- Tiffany Shaniah Sanchez
- Sharlene Nicole Sandoval
- Mariah Wall
- Deborah Jan Wilson
- Susan L Windeck
All providers in Tierra Amarilla, NM · Dentist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.