Individual provider Active NPI

Rachel Marie Glancy, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salem, OR
National Provider Identifier
1508973686
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D7098 Issued in OR
Practice address
5135 Skyline Rd S
Salem, OR 97306-9427
Phone
(503) 588-6560
Fax
(503) 371-9822
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D7098 OR Primary

Addresses

Primary practice location

5135 Skyline Rd S
Salem, OR 97306-9427

Mailing address

3222 Sunridge Dr S
Salem, OR 97302-5949
Phone (503) 588-5680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110627000755 OR Order and Referring Only - DentistPractitioner - Dentist 4082892815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7098ORMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Permanente 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508973686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 SUNRIDGE DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025949",
            "telephone_number": "503-588-5680",
            "fax_number": "503-588-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 SKYLINE RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069427",
            "telephone_number": "503-588-6560",
            "fax_number": "503-371-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANCY",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "D7098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.