Glenn Dupont, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8149 Issued in FL

Practice address

111 2ND Ave NE
Suite #1104
Saint Petersburg, FL 33701-3434

Phone

(727) 821-4433

Fax

(727) 822-7252

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• International Center for Complete Dentistry

  • Customized Equipment (DME)
  • St Petersburg, FL
  • NPI 1154643377
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295851293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "address_2": "SUITE #1104",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "727-821-4433",
            "fax_number": "727-822-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "address_2": "SUITE #1104",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "727-821-4433",
            "fax_number": "727-822-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "8149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra S. Dunn, MSW, LCSW
• Vanessa I. Dunsmore, PTA
• Pauline Dunstan
• Linh My Duong
• Kristina Zannis Duplantis, BCBA, SLPA
• Denise Dupree, AP,LAC, MAC
• Simone Danielle Durant, HAIR LOSS SPECIALIST
• Andrew James Duren, MD
• Melinda Lane Duren, ARNP
• Joseph Mathew Durgin, LCSW

• General Practice Dentistry in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.