Todd G. Glazener, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6985 Issued in NC

Practice address

3465 Polo Rd
Winston Salem, NC 27106-4828

Phone

(336) 774-0520

Fax

(336) 774-6533

NPI assigned

May 7, 2007

Last updated

Sep 24, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• A.E. Underwood Ddstodd Glazener

  • General Practice Dentistry
  • Winston Salem, NC
  • NPI 1568590271
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1619180924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 POLO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064828",
            "telephone_number": "336-774-0520",
            "fax_number": "336-774-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 POLO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064828",
            "telephone_number": "336-774-0520",
            "fax_number": "336-774-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZENER",
        "first_name": "TODD",
        "middle_name": "G.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Dawn Glass, DNP
• Casey M Glass, MD
• Charity Glass, MD
• Jasmine Simone Glass, WHNP
• Tamila Glass, RBT
• Julie Kristen Gleim, LCMHC
• Katelyn Glen, PA-C
• Ashley Glenn, MA, CCC-SLP
• David Locke Glenn III, MD
• Hayden Glenn

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.