Active NPI
Stephen O Glenn, DDS
- General Practice Dentistry
- Tulsa, OK
National Provider Identifier
1346276151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3665
- Practice address
- 5319 S Lewis Ave
Suite 222
Tulsa, OK 74105-6500 - Phone
- (918) 748-8484
- Fax
- (918) 744-0761
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- 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 | 3665 | OK | Primary |
Addresses
Primary practice location
5319 S Lewis Ave
Suite 222
Tulsa, OK 74105-6500
Mailing address
5319 S Lewis Ave
Suite 222
Tulsa, OK 74105-6500
Phone (918) 748-8484
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 |
|---|---|---|---|
| 3665 | OK | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen O. Glenn, DDS | Past | Accepting new patients | |
| LPFD PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Tulsa, OK
- NPI 1962676817
-
- Dentist
- Tulsa, OK
- NPI 1619563525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346276151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5319 S LEWIS AVE",
"address_2": "SUITE 222",
"city": "TULSA",
"state": "OK",
"postal_code": "741056500",
"telephone_number": "918-748-8484",
"fax_number": "918-744-0761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5319 S LEWIS AVE",
"address_2": "SUITE 222",
"city": "TULSA",
"state": "OK",
"postal_code": "741056500",
"telephone_number": "918-748-8484",
"fax_number": "918-744-0761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "STEPHEN",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "3665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- 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.