Glen David Maylath, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901014767 Issued in MI

Practice address

50 W Big Beaver Rd Ste 120
Bloomfield Hills, MI 48304-3911

Phone

(248) 642-5020

NPI assigned

Oct 27, 2006

Last updated

Dec 4, 2013By 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 MI

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

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Total Dental Fitness

  • General Practice Dentistry
  • Bloomfield Hills, MI
  • NPI 1265863021
  Authorized official Same address or phone

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1780769570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W BIG BEAVER RD STE 120",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043911",
            "telephone_number": "248-642-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W BIG BEAVER RD STE 120",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043911",
            "telephone_number": "248-642-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYLATH",
        "first_name": "GLEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen a Kelly MD PLLC (Bloomfield Pediatric Care)
• Cynthia Maurer, MPT
• Maximum Care Services LLC
• Carla Marie Maxwell
• Timothy Arthur Mayer, D.D.S.
• Christina Louise Mayo, PHD,LLP
• Shaleene Mayo
• Daniel Joseph McAleer, D.C.
• Roy D McAnnally, DMD
• Jazmine McBride, LLMSW

• General Practice Dentistry in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.