NPIMap

Organization Active NPI

Jon Erik Glenn DDS a Professional Corporation

  • Dentist
  • Newport Beach, CA
National Provider Identifier
1699204057
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JON ERIK GLENN DDS A PROFESSIONAL CORPORATION
Practice address
400 Newport Center Dr.
Suite 607
Newport Beach, CA 92660-7625
Phone
(949) 644-0071
Fax
(949) 717-0685
NPI assigned
Jun 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jon GlennNPI 1497856488
Title
Owner
Phone
(949) 644-0071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

400 Newport Center Dr.
Suite 607
Newport Beach, CA 92660-7625

Mailing address

400 Newport Center Dr Ste 607
Newport Beach, CA 92660-7625
Phone (949) 644-0071

National Provider Directory

National Provider Directory

Locations

400 Newport Center Dr
Ste 607
Newport Beach, CA 92660
Phone (949) 644-0071

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699204057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR STE 607",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607625",
            "telephone_number": "949-644-0071",
            "fax_number": "949-717-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR.",
            "address_2": "SUITE 607",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607625",
            "telephone_number": "949-644-0071",
            "fax_number": "949-717-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON ERIK GLENN DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-644-0071"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.