Brandon Norman Glenn, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

10067031-9922 Issued in UT

Practice address

2854 W 4700 S
Suite B
Taylorsville, UT 84129-2102

Phone

(801) 432-7773

Fax

(801) 679-1958

NPI assigned

Jun 20, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1598104853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 W 4700 S",
            "address_2": "SUITE B",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841292102",
            "telephone_number": "801-432-7773",
            "fax_number": "801-679-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2854 W 4700 S",
            "address_2": "SUITE B",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841292102",
            "telephone_number": "801-432-7773",
            "fax_number": "801-679-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "BRANDON",
        "middle_name": "NORMAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "10067031-9922",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.023962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gilson
• Casey Ginn
• Stephen Kiuri Gitonga, PH.D., ACS, LCMHC
• Chelzee Kael Given
• Amanda Jo Glenn
• Addison Goeckeritz
• Jade Goedicke
• Kayla Goetz, DPT
• Jennifer Kay Golden
• Sarah Goldman, PHD

• Endodontics in Taylorsville, UT
• Providers in Taylorsville, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.