Jon Erik Glenn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35723 Issued in CA

Practice address

400 Newport Center Dr
Suite 607
Newport Beach, CA 92660-7625

Phone

(949) 644-0071

Fax

(949) 717-0685

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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

Medicare enrollment (NPD)

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.

• Jon Erik Glenn DDS a Professional Corporation

  • Dentist
  • Newport Beach, CA
  • NPI 1699204057
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497856488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DRIVE",
            "address_2": "SUITE 607",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607625",
            "telephone_number": "949-644-0071",
            "fax_number": "949-717-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR",
            "address_2": "SUITE 607",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607625",
            "telephone_number": "949-644-0071",
            "fax_number": "949-717-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JON",
        "middle_name": "ERIK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory R. Glass, D. D. S.
• Beth Dana Glasser, D.C.
• Eric Victor Glassman, PA-C
• Glenn D. Madokoro, M.D, F.a.C.G., Inc.
• Glenn E. Cripe, DC, Inc
• Global Premier Fertility - Orange County PC Dba Rise Fertility
• Arie Vadim Gluzman, M.D.
• GMT Inc.
• Michael L Goddard, D.P.M.
• William Alan Godden

• General Practice Dentistry in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.