Individual provider Active NPI

William A Glover III, DMD, MAGD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1265574776
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11757 Issued in FL
Practice address
1507 S Hiawasse Rd
Suite 209
Orlando, FL 32835
Phone
(407) 522-5595
Fax
(407) 522-5598
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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 11757 FL Primary

Addresses

Primary practice location

1507 S Hiawasse Rd
Suite 209
Orlando, FL 32835

Mailing address

1507 S. Hiawassee Rd
Suite 209
Orlando, FL 32835
Phone (407) 522-5595

Other identifiers 1

IdentifierTypeStateIssuer
072886100MedicaidFL

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
11757FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
William Glover III DMD LLC General Practice Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1265574776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S. HIAWASSEE RD",
            "address_2": "SUITE 209",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32835",
            "telephone_number": "407-522-5595",
            "fax_number": "407-522-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S HIAWASSE RD",
            "address_2": "SUITE 209",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32835",
            "telephone_number": "407-522-5595",
            "fax_number": "407-522-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD, MAGD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "11757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072886100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.