Active NPI
Glenn Thomas Ashworth, D.D.S.
- Dentist
- Tacoma, WA
National Provider Identifier
1467760850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE 60462145
- Practice address
- 3820 Pacific Ave
Suite 101
Tacoma, WA 98418-7825 - Phone
- (716) 425-6295
- NPI assigned
- Sep 20, 2010
- Last updated
- May 19, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE 60462145 | WA | Primary |
| General Practice Dentistry | 1223G0001X | 14600 | MD |
Addresses
Primary practice location
3820 Pacific Ave
Suite 101
Tacoma, WA 98418-7825
Mailing address
3820 Pacific Ave
Suite 101
Tacoma, WA 98418-7825
Phone (716) 425-6295
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 14, 2022 through Dec 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE 60462145 | WA | MD | Dentist |
| 14600 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Tacoma Dental PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431993600000",
"number": "1467760850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3820 PACIFIC AVE",
"address_2": "SUITE 101",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187825",
"telephone_number": "716-425-6295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3820 PACIFIC AVE",
"address_2": "SUITE 101",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187825",
"telephone_number": "716-425-6295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHWORTH",
"first_name": "GLENN",
"middle_name": "THOMAS",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-20",
"last_updated": "2015-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE 60462145",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "14600",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.