Active NPI
Frances Jacqueline Glenn, DMD
- General Practice Dentistry
- Nutley, NJ
National Provider Identifier
1295957207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DIO15979
- Practice address
- 684 Passaic Ave
Suite 100-C
Nutley, NJ 07110-1267 - Phone
- (973) 667-2400
- Fax
- (973) 667-3196
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DIO15979 | NJ | Primary |
Addresses
Primary practice location
684 Passaic Ave
Suite 100-C
Nutley, NJ 07110-1267
Mailing address
16 Ernest St.
Nutley, NJ 07110
Phone (973) 667-2400
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 |
|---|---|---|---|
| 22DIO15979 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224115200000",
"number": "1295957207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 ERNEST ST.",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "07110",
"telephone_number": "973-667-2400",
"fax_number": "973-667-3196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "684 PASSAIC AVE",
"address_2": "SUITE 100-C",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071101267",
"telephone_number": "973-667-2400",
"fax_number": "973-667-3196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "FRANCES",
"middle_name": "JACQUELINE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2008-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DIO15979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.