Active NPI
Mark Erwin Glover, D.D.S.,M.S.D.
- Periodontics
- Dallas, TX
National Provider Identifier
1215057989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 11652
- Practice address
- 8226 Douglas Ave Ste 601
Dallas, TX 75225-5928 - Phone
- (214) 691-5593
- NPI assigned
- Mar 29, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 11652 | TX | Primary |
Addresses
Primary practice location
8226 Douglas Ave Ste 601
Dallas, TX 75225-5928
Mailing address
8226 Douglas Ave Ste 601
Dallas, TX 75225-5928
Phone (214) 691-5593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 21, 2015 through Jul 21, 2027
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": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215057989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8226 DOUGLAS AVE STE 601",
"city": "DALLAS",
"state": "TX",
"postal_code": "752255928",
"telephone_number": "214-691-5593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8226 DOUGLAS AVE STE 601",
"city": "DALLAS",
"state": "TX",
"postal_code": "752255928",
"telephone_number": "214-691-5593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "MARK",
"middle_name": "ERWIN",
"credential": "D.D.S.,M.S.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "11652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.