Individual provider Active NPI

Nelson D. Glassett, DDS

  • Dentist
  • Draper, UT
National Provider Identifier
1588768048
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
042970659 Issued in UT
Practice address
11576 S State St
Suite 1203
Draper, UT 84020-6431
Phone
(801) 619-8664
Fax
(801) 619-8787
NPI assigned
Sep 12, 2006
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042970659 UT Primary

Addresses

Primary practice location

11576 S State St
Suite 1203
Draper, UT 84020-6431

Mailing address

11576 South State Street
Suite 1203
Draper, UT 84020-7118
Phone (801) 619-8664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20250129000575 UT Practitioner - Dentist 1951840966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042970659UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Dreams Ut LLC Dentist CurrentSince Dec 7, 2024 Accepting new patients
Nelson D. Glassett LLC General Practice PastSince Dec 7, 2024 Accepting new patients

Locations

11576 S State St
Ste 1203
Draper, UT 84020
Phone (801) 619-8664

Organizations & group practices 2

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1588768048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11576 SOUTH STATE STREET",
            "address_2": "SUITE 1203",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207118",
            "telephone_number": "801-619-8664",
            "fax_number": "801-619-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11576 S STATE ST",
            "address_2": "SUITE 1203",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840206431",
            "telephone_number": "801-619-8664",
            "fax_number": "801-619-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSETT",
        "first_name": "NELSON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "042970659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.