Individual provider Active NPI

Tia Glanding, RDH, CMT, OMT

  • Dental Hygienist
  • Grants Pass, OR
National Provider Identifier
1366051955
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
Practice address
490 W Pickett Creek Rd
Grants Pass, OR 97527-9668
Phone
(541) 660-5306
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X Primary

Addresses

Primary practice location

490 W Pickett Creek Rd
Grants Pass, OR 97527-9668

Mailing address

490 W Pickett Creek Rd
Grants Pass, OR 97527-9668
Phone (541) 660-5306

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.pnwmyo.com Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1366051955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 W PICKETT CREEK RD",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975279668",
            "telephone_number": "541-660-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 W PICKETT CREEK RD",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975279668",
            "telephone_number": "541-660-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANDING",
        "first_name": "TIA",
        "credential": "RDH, CMT, OMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.pnwmyo.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "490 W Pickett Creek Rd",
            "city": "Grants Pass",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975279668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.