Dudley Brewer Glass, Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4494 Issued in KY

Practice address

1002 Lexington Rd
Ste. 20
Georgetown, KY 40324-1463

Phone

(502) 863-5442

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619983863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 LONG LICK PIKE",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249462",
            "telephone_number": "502-535-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 LEXINGTON RD",
            "address_2": "STE. 20",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241463",
            "telephone_number": "502-863-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS, JR.",
        "first_name": "DUDLEY",
        "middle_name": "BREWER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "4494",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerogetown Community Hospital LLC
• Anne-Claire Gibson, RBT
• Heath Martin Gibson, PA-C
• Jessica N Gibson, PT, DPT
• Stacee Marie Gibson, ATC
• Dustin Michael Golebieski, DPT
• Michael Goodwin, D.O.
• Shon L Goodwin, M.S.
• Janette A Graham, PT
• Rebeccah Grace Gray

• General Practice Dentistry in Georgetown, KY
• Providers in Georgetown, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.