Gregory L Glade DMD PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREGORY L GLADE DMD PC

Practice address

308 11TH St North
Port Byron, IL 61275-9038

Phone

(309) 523-3325

Fax

(309) 523-9078

NPI assigned

Oct 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Bernadette L Glade

Title

Secretary of PC Office Manager

Phone

(309) 523-3325

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sydney Christine Delgadillo, DMD

  • Dentist
  • Port Byron, IL
  • NPI 1053980243
  NPD (past)
• Gregory L Glade, DMD

  • Dentist
  • Port Byron, IL
  • NPI 1548367600
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609965763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 11TH ST NORTH",
            "city": "PORT BYRON",
            "state": "IL",
            "postal_code": "612759038",
            "telephone_number": "309-523-3325",
            "fax_number": "309-523-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 11TH ST NORTH",
            "city": "PORT BYRON",
            "state": "IL",
            "postal_code": "612759038",
            "telephone_number": "309-523-3325",
            "fax_number": "309-523-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY L GLADE DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLADE",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY OF PC OFFICE MANAGER",
        "authorized_official_telephone_number": "309-523-3325",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galva Family Dentistry, Inc. (Port Byron Family Dentistry)
• Genesis Health System (Genesis Health Group)
• Barbara Ann Gillman, DT
• Gregory L Glade, DMD
• Sarah Lynn Goodson, LCSW
• Abigail Martina Johnson, ATC
• Heather Renee Lowry, NP-C
• Patricia Ann Mayo, SLP
• Rhonda Lynn Owens
• Frederick Bruce Perry, D.O.

• Dentist in Port Byron, IL
• Providers in Port Byron, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.