Individual provider Active NPI

Glena Patricia Millan, DMD

  • Prosthodontics
  • Brighton, MA
National Provider Identifier
1659527992
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
9706 Issued in MA
Practice address
495 Western Ave
Brighton, MA 02135-1007
Phone
(617) 783-0500
Fax
(617) 562-1398
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 9706 MA Primary

Addresses

Primary practice location

495 Western Ave
Brighton, MA 02135-1007

Mailing address

100 E Newton St
RM G401
Boston, MA 02118-2308
Phone (617) 638-4705

Other practice location 1

100 E Newton St
Rm G401
Boston, MA 02118-2308
Phone (617) 638-4705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150507000086 MA Practitioner - Oral Surgery 1052630464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9706MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charles River Community Health, Inc CurrentSince Oct 4, 2013 Accepting new patients
Charles River Community Health Inc CurrentSince Oct 4, 2013 Accepting new patients
Mt Auburn Professional Services Past Accepting new patients
Trustees of Boston University Prosthodontics Past Accepting new patients

Locations

287 Western Ave
Allston, MA 02134
Phone (781) 693-3849

495 Western Ave
Brighton, MA 02135

43 Foundry Ave
Ste 110
Waltham, MA 02453
Phone (781) 693-3800

Interoperability endpoints

  • Direct secure messaging: gmillan20185@direct.ctc.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1659527992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST",
            "address_2": "RM G401",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4705",
            "fax_number": "617-638-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WESTERN AVE",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351007",
            "telephone_number": "617-783-0500",
            "fax_number": "617-562-1398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Newton St",
            "address_2": "Rm G401",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182308",
            "country_code": "US",
            "telephone_number": "617-638-4705",
            "fax_number": "617-638-4713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLAN",
        "first_name": "GLENA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "9706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.