Glick Orthodontics, P.C.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

19785 Issued in MA

Legal business name

GLICK ORTHODONTICS, P.C.

Practice address

16 Park St
Medfield, MA 02052-2518

Phone

(508) 359-2576

Fax

(508) 359-2291

NPI assigned

Apr 21, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Geoffrey Michael Glick, DMD

Title

President

Phone

(508) 359-2576

Specialties & licenses 1

Addresses

Other names 1

• Dr. Starr and Dr. Glick Doing business as

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1295052900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PARK ST",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020522518",
            "telephone_number": "508-359-2576",
            "fax_number": "508-359-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PARK ST",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020522518",
            "telephone_number": "508-359-2576",
            "fax_number": "508-359-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLICK ORTHODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-359-2576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "19785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Starr and Dr. Glick",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Gentile
• Debra Susan Gerstein, MD
• Mojtaba Ghavidel
• Kelly Ann Gibbons, M.S., CCC-SLP
• Ellen C. Gleason, M.S., CCC-SLP
• Geoffrey Michael Glick, D.M.D.
• Pamela S Godsoe, CCC-SLP
• Stanley Joel Goodman, CNP
• Deanna P. Groen, DDS
• Hannah Hakim

• All providers in Medfield, MA
• Orthodontics and Dentofacial Orthopedics Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.