Glenn R Justice, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3072 Issued in NV

Practice address

9484 W Lake Mead Blvd Ste 2
Las Vegas, NV 89134-8339

Phone

(702) 304-8338

Fax

(702) 304-0733

NPI assigned

Jul 5, 2006

Last updated

May 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• David Ting DMD a Professional

  dba Boston Dental

  • Dental Clinic/Center
  • Las Vegas, NV
  • NPI 1497911812
  NPD Authorized official

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1790716355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4782 HEARTSTONE CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891290403",
            "telephone_number": "702-493-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9484 W LAKE MEAD BLVD STE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891348339",
            "telephone_number": "702-304-8338",
            "fax_number": "702-304-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "GLENN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Just
• Cynthia Justafort
• Jonathan Bo Juste, MD
• Tylor Jordon Justice-Page
• Ashley Justice
• Jeffrey Justice, RN
• Kristy Justice
• Stephanie Monique Justice
• Kyra Justin
• Eileen Pablo Justo, APRN-CNP

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.