James William Glen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29595 Issued in CA

Practice address

6633 La Jolla Blvd
La Jolla, CA 92037-6019

Phone

(858) 454-3060

NPI assigned

May 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740497197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6633 LA JOLLA BLVD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376019",
            "telephone_number": "858-454-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6633 LA JOLLA BLVD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376019",
            "telephone_number": "858-454-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEN",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Serge Giritsky, MD
• Lindsey Giunta, PSYD
• Daniel Given, M.D.
• Christian Michael Glackin, DDS
• Daniel Scott Glasser
• Tara Jackson Glenn, MD
• Samuel R. Glickman, M.D.
• Danielle Kukene Glorioso, LCSW
• Walter Goff, D.O.
• Miguel A Goicoechea, M.D.

• General Practice Dentistry in La Jolla, CA
• Providers in La Jolla, CA by specialty
• General Practice Dentistry in California

• 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.
• 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.