Glenn S. Fung, DMD., Inc

Primary specialty

DentistTaxonomy code 122300000X

License

39957 Issued in CA

Legal business name

GLENN S. FUNG, DMD., INC

Practice address

885 Markham Ave
Vacaville, CA 95688-2988

Phone

(707) 448-8851

NPI assigned

Oct 22, 2008

Last updated

Oct 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glenn S. Fung, D.M.DNPI 1376600205

Title

President

Phone

(707) 448-8851

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenn S Fung, DMD

  • Dentist
  • Vacaville, CA
  • NPI 1376600205
  NPD (past) Authorized official

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1174775092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 MARKHAM AVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956882988",
            "telephone_number": "707-448-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 MARKHAM AVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956882988",
            "telephone_number": "707-448-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN S. FUNG, DMD., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "FUNG",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-448-8851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simran Singh Gill, DDS
• Supria K. Gill, PHD
• Kyla Gish, LE
• Ashley Gisi
• Elizabeth Marie Gladney, AGACNP-BC
• Jeffrey Michael Gless, O.D.
• Mark William Gloudeman, PHARMD, CDE
• Benny Alvin Glover, M.A., LMFT
• Sebastian Go
• Shiela Mae Gulapa Go, RN

• Dentist in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.