Individual provider Active NPI

Glenn Scott Kupfer, D.D.S.

  • General Practice Dentistry
  • Coral Springs, FL
National Provider Identifier
1386752376
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN9256 Issued in FL
Practice address
4944 NW 97TH Dr
Coral Springs, FL 33076-2454
Phone
(954) 803-5538
NPI assigned
Aug 29, 2006
Reactivated
Aug 8, 2014
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN9256 FL Primary

Addresses

Primary practice location

4944 NW 97TH Dr
Coral Springs, FL 33076-2454

Mailing address

4944 NW 97TH Dr
Coral Springs, FL 33076-2454
Phone (954) 803-5538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150320001883 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8325365810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forma Dent PA General Practice PastSince Apr 6, 2021 Accepting new patients
Glenn S. Kupfer, D.D.S. General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1386752376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944 NW 97TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762454",
            "telephone_number": "954-803-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4944 NW 97TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762454",
            "telephone_number": "954-803-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPFER",
        "first_name": "GLENN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "deactivation_date": "2007-05-11",
        "reactivation_date": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.