Active NPI
Glenda Gill
- Dental Assistant
- Maynardville, TN
National Provider Identifier
1780155960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 4330 Maynardville Hwy
Maynardville, TN 37807-3618 - Phone
- (865) 992-3849
- Fax
- (865) 992-5166
- NPI assigned
- Dec 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
4330 Maynardville Hwy
Maynardville, TN 37807-3618
Mailing address
1923 Sulphur Springs Rd
Morristown, TN 37813-5654
Phone (423) 317-9344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544918400000",
"number": "1780155960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1923 SULPHUR SPRINGS RD",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "378135654",
"telephone_number": "423-317-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4330 MAYNARDVILLE HWY",
"city": "MAYNARDVILLE",
"state": "TN",
"postal_code": "378073618",
"telephone_number": "865-992-3849",
"fax_number": "865-992-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILL",
"first_name": "GLENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-16",
"last_updated": "2018-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maynardville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.