Kirt Glenn, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7624 Issued in OR

Practice address

102 E Bishop Way
Brownsville, OR 97327-2165

Phone

(541) 466-5171

NPI assigned

Sep 15, 2005

Last updated

Mar 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1174518195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E BISHOP WAY",
            "city": "BROWNSVILLE",
            "state": "OR",
            "postal_code": "973272165",
            "telephone_number": "541-223-8781",
            "fax_number": "541-466-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E BISHOP WAY",
            "city": "BROWNSVILLE",
            "state": "OR",
            "postal_code": "973272165",
            "telephone_number": "541-466-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "KIRT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Linn School
• Chriszma Erickson, LAC
• Joseph Ervin, RPH
• Ervins Development Inc (Brownsville Pharmacy)
• David Lawrence Federoff, PA
• Richard B Halbur, PAC
• Lester M. Hands, M.D.
• Lynsey Elizabeth Hostetter, CD(DONA)
• Lester Hands, MD, LLC (Brownsville Clinic)
• Mid-Valley Healthcare, Inc. (Samaritan Family Medicine-Brownsville)

• General Practice Dentistry in Brownsville, OR
• Providers in Brownsville, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.