Stephen Glaze, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009600 Issued in AZ

Practice address

9015 N 3Rd St
Phoenix, AZ 85020-2444

Phone

(480) 882-4545

Fax

(602) 409-0499

NPI assigned

Feb 10, 2016

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sglaze663920@direct.ochin.org
• Direct secure messaging: sglaze701685@direct.ochin.org

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.

• Salt River Pima-Maricopa Indian Community

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1942668991

  TX

  Medicare reassignment NPD
• Salt River Pima-Maricopa Indian Community

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1538583125
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1669878567
  NPD (past)
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1760840300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202444",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2702 N 3rd St Ste 4020",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850044608",
            "country_code": "US",
            "telephone_number": "602-323-3492",
            "fax_number": "602-323-3399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLAZE",
        "first_name": "STEPHEN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212826",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Storm Glassheart, RBT
• Daniel Glassman
• David Isaac Glassman, D.O.
• Susan H Glavic, MSCCC SLP
• Megan Glawischnig, PHD
• Richard I Glazer, DMD
• Carly Jo Glazier-Kersavage, OTD
• Ron Glazier
• Donna J Gleason, NP, CRNFA
• Paul John Gleason, P.T.

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.