Active NPI
Jeffrey W Glynn, DDS
- Dentist
- Galion, OH
National Provider Identifier
1093876641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30-01-8095
- Practice address
- 112 S Market St
Galion, OH 44833-2626 - Phone
- (419) 468-1100
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30-01-8095 | OH | Primary |
Addresses
Primary practice location
112 S Market St
Galion, OH 44833-2626
Mailing address
112 S Market St
Galion, OH 44833-2626
Phone (419) 468-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0616695 | Medicaid | OH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190332800000",
"number": "1093876641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 S MARKET ST",
"city": "GALION",
"state": "OH",
"postal_code": "448332626",
"telephone_number": "419-468-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 S MARKET ST",
"city": "GALION",
"state": "OH",
"postal_code": "448332626",
"telephone_number": "419-468-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLYNN",
"first_name": "JEFFREY",
"middle_name": "W",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30-01-8095",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0616695",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Galion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.