NPIMap

Individual provider Active NPI

Glen David Blanchard, D.D.S.

  • General Practice Dentistry
  • Carrollton, TX
National Provider Identifier
1205948619
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14021 Issued in TX
Practice address
4364 N Josey LN
Carrollton, TX 75010-4602
Phone
(972) 394-1492
Fax
(972) 394-8650
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 14021 TX Primary

Addresses

Primary practice location

4364 N Josey LN
Carrollton, TX 75010-4602

Mailing address

4364 N Josey LN
Carrollton, TX 75010-4602
Phone (972) 394-1492

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
14021TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Designs of Carrollton, P.a. General Practice Past Accepting new patients
Anthony Dillard DDS PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205948619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4364 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104602",
            "telephone_number": "972-394-1492",
            "fax_number": "972-394-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4364 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104602",
            "telephone_number": "972-394-1492",
            "fax_number": "972-394-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "GLEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.