Individual provider Active NPI

Glenn Alan Macfarlane, D.M.D.

  • Dentist
  • Red Bank, NJ
National Provider Identifier
1578620639
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI15235 Issued in NJ
Practice address
211 Broad St Ste 106
Red Bank, NJ 07701-2009
Phone
(732) 517-7785
Fax
(732) 284-3170
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI15235 NJ Primary

Addresses

Primary practice location

211 Broad St Ste 106
Red Bank, NJ 07701-2009

Mailing address

211 Broad Street
Suite 106
Red Bank, NJ 07701-2009
Phone (732) 517-7785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI15235NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Macfarlane Dental Associates LLC Dentist CurrentSince Jul 24, 2022 Accepting new patients

Locations

211 Broad St
Ste 106
Red Bank, NJ 07701
Phone (732) 517-7785

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": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1578620639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BROAD STREET",
            "address_2": "SUITE 106",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012009",
            "telephone_number": "732-517-7785",
            "fax_number": "732-284-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BROAD ST STE 106",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012009",
            "telephone_number": "732-517-7785",
            "fax_number": "732-284-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACFARLANE",
        "first_name": "GLENN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI15235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.