Jason P Glassley, D.D.S., M.S.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

12010736A Issued in IN

Practice address

5718 Coventry LN
Fort Wayne, IN 46804-7141

Phone

(260) 436-5772

Fax

(260) 436-5779

NPI assigned

Jun 29, 2008

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 IN

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 and National Provider Directory roles.

• Fort Wayne Endodontics

  • Endodontics
  • Fort Wayne, IN
  • NPI 1083265433
  NPD (past) Authorized official

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

{
    "created_epoch": "1214697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214697600000",
    "number": "1679735898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 GALAPAGOS CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468148872",
            "telephone_number": "260-436-5772",
            "fax_number": "260-436-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-436-5772",
            "fax_number": "260-436-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSLEY",
        "first_name": "JASON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-29",
        "last_updated": "2008-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12010736A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane E Glass, R.D.
• Tia Ila Marie Glass
• Caley Glassburn
• Glassley & Marr Dental Group, P.C.
• Gregory S Glassley, DDS
• Jeffrey L Glassley, DDS
• Michael Robert Glassley, D.D.S.
• Sara Glassley, NP
• Scott M Glassley, DDS
• Stephen H. Glassley, M.D.

• Endodontics in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Endodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2008; 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.