Individual provider Active NPI

Tressa Mollie-Marie Gloystein, DDS

  • Dentist
  • Grand Island, NE
National Provider Identifier
1306463963
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NE-7781 Issued in NE
Practice address
2504 N Webb Rd Ste 1338
Grand Island, NE 68803-1338
Phone
(402) 519-3768
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS-09762 IA
Dentist 122300000X NE-7781 NE Primary

Addresses

Primary practice location

2504 N Webb Rd Ste 1338
Grand Island, NE 68803-1338

Mailing address

2504 N Webb Rd Ste 1338
Grand Island, NE 68803-1338
Phone (402) 519-3768

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

LicenseStateTypeSpecialty
DDS-09762IAMDDentist
NE-7781NEMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1306463963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 N WEBB RD STE 1338",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688031338",
            "telephone_number": "402-519-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 N WEBB RD STE 1338",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688031338",
            "telephone_number": "402-519-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOYSTEIN",
        "first_name": "TRESSA",
        "middle_name": "MOLLIE-MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09762",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "NE-7781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.