Stephen Eric Glick, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

401410243 Issued in VA

Practice address

1600 Hockett Rd
Manakin Sabot, VA 23103-2229

Phone

(804) 784-4150

Fax

(804) 784-1232

NPI assigned

Jul 25, 2006

Last updated

Jul 29, 2011By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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.

• Stephen E Glick DDS PC

  • General Practice Dentistry
  • Manakin Sabot, VA
  • NPI 1790237915
  NPD (past) Authorized official
• Stephen E. Glick, DDS, PC

  • General Practice Dentistry
  • Manakin Sabot, VA
  • NPI 1285741421
  NPD (past) Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1669495693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HOCKETT RD",
            "city": "MANAKIN SABOT",
            "state": "VA",
            "postal_code": "231032229",
            "telephone_number": "804-784-4150",
            "fax_number": "804-784-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HOCKETT RD",
            "city": "MANAKIN SABOT",
            "state": "VA",
            "postal_code": "231032229",
            "telephone_number": "804-784-4150",
            "fax_number": "804-784-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "STEPHEN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "401410243",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Ervin I, M.D., FACEP
• Family Care Services, LLC
• Family Chiropractic Center of Richmond, LLC
• Linda Fletcher, M. EDUC. SCHOOL COUN
• Nicole Jeanette Galletta, OTRL
• Berta Lisbeth Granados Ortega, M.D.
• Heidi Ellen Greene, MPT
• Elizabeth G Hall, NP
• Meisha Harris
• Paula Harrison

• General Practice Dentistry in Manakin Sabot, VA
• Providers in Manakin Sabot, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.