NPIMap

Organization Active NPI

Glenn J. Marie, DDS, PC

  • Pediatric Dentistry
  • Staten Island, NY
National Provider Identifier
1760609275
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
040958 Issued in NY
Legal business name
GLENN J. MARIE, DDS, PC
Practice address
739 Woodrow Rd
Staten Island, NY 10312-2221
Phone
(718) 317-8524
Fax
(718) 984-6644
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Authorized official

Name
Dr. Glenn J. Marie, DDS
Title
Pres.
Phone
(718) 317-8524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 040958 NY Primary

Addresses

Primary practice location

739 Woodrow Rd
Staten Island, NY 10312-2221

Mailing address

PO Box 4038
Middletown, NJ 07748-4038

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1760609275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4038",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077484038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 WOODROW RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122221",
            "telephone_number": "718-317-8524",
            "fax_number": "718-984-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN J. MARIE, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "MARIE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "718-317-8524",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "040958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.