Kaitlyn Sundby Glogoza, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D46149 Issued in MN

Practice address

706 Demers Ave
East Grand Forks, MN 56721-1842

Phone

(218) 773-7474

NPI assigned

Jul 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Demers Dental

  • Dentist
  • East Grand Forks, MN
  • NPI 1366734295
  NPD (past)

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1417635459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4177 S COLUMBIA RD",
            "address_2": "APT 415",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "218-478-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211842",
            "telephone_number": "218-773-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOGOZA",
        "first_name": "KAITLYN",
        "middle_name": "SUNDBY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D46149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Stephanie Fundaun, PHARMD
• Cathy A Galstad, MS CCC/SLP
• Steven Phillip Gander, O.D.
• Mridu Gandhi, MD
• Harriet J Gibbons, PA-C
• Dorothy Gomez
• Mathew T Grasser, PT
• Callie J Greene, DPT
• Denae D Grove, LRD
• Lisa Gunderson, PHARMD

• General Practice Dentistry in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.