Active NPI
Glenn Charles Utz, D.M.D
- Dentist
- Florence, KY
National Provider Identifier
1275761041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6216
- Practice address
- 1120 Boone Aire Rd
Florence, KY 41042-1212 - Phone
- (859) 371-6699
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6216 | KY | Primary |
Addresses
Primary practice location
1120 Boone Aire Rd
Florence, KY 41042-1212
Mailing address
1120 Boone Aire Rd
Florence, KY 41042-1212
Phone (859) 371-6699
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6216 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1275761041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 BOONE AIRE RD",
"city": "FLORENCE",
"state": "KY",
"postal_code": "410421212",
"telephone_number": "859-371-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 BOONE AIRE RD",
"city": "FLORENCE",
"state": "KY",
"postal_code": "410421212",
"telephone_number": "859-371-6699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTZ",
"first_name": "GLENN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "6216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.