Glen Royden Dean, DDS MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

104423 Issued in CO

Practice address

2552 F Rd
Grand Junction, CO 81505-1422

Phone

(970) 241-1313

Fax

(970) 241-5202

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Oral Health Partners, Professional LLC

  • Dentist
  • Grand Junction, CO
  • NPI 1275795106
  NPD (past) Authorized official
• Ruby Canyon Dental Group, PC

  • General Practice Dentistry
  • Grand Junction, CO
  • NPI 1518340694

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1275696114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 F RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051422",
            "telephone_number": "970-241-1313",
            "fax_number": "970-241-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 F RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051422",
            "telephone_number": "970-241-1313",
            "fax_number": "970-241-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "GLEN",
        "middle_name": "ROYDEN",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "104423",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "1356539922",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02044238",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison De Arman
• Chris De Bruin, LPC
• Cheryl Claire De Gaia, RPH
• Mary J De Young
• Derek Langford Dean, DDS
• Joel M Dean, DO
• Deborah a Wheeler MD LLC
• Decatur Vein Clinic Colorado PC (Colorado Vein Clinic PC)
• Jake Decker, R.PH.
• Jennifer Decker, ATC

• Pediatric Dentistry in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.