Individual provider Active NPI

Robert Wallace Glineburg, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Paul, MN
National Provider Identifier
1225091150
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8257 Issued in MN
Practice address
1630 University Ave W
Suite 104
Saint Paul, MN 55104-3887
Phone
(651) 646-9474
NPI assigned
Apr 11, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8257 MN Primary

Addresses

Primary practice location

1630 University Ave W
Suite 104
Saint Paul, MN 55104-3887

Mailing address

1849 Pinehurst Ave
Saint Paul, MN 55116-1336
Phone (651) 698-3937

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8257MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert W. Glineburg, D.D.S., M.S., P.a. Oral and Maxillofacial Surgery PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225091150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 PINEHURST AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161336",
            "telephone_number": "651-698-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 UNIVERSITY AVE W",
            "address_2": "SUITE 104",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043887",
            "telephone_number": "651-646-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLINEBURG",
        "first_name": "ROBERT",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "8257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.