Individual provider Active NPI

Caroline Elise Glessner, DMD

  • Dentist
  • Atlanta, GA
National Provider Identifier
1801548714
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN122735 Issued in GA
Practice address
2847 Henderson Mill Road
Atlanta, GA 30341
Phone
(678) 602-0082
NPI assigned
Jan 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DN122735 GA Primary

Addresses

Primary practice location

2847 Henderson Mill Road
Atlanta, GA 30341

Mailing address

2847 Henderson Mill Road
Atlanta, GA 30341

Other practice location 1

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001
Phone (706) 721-2371

Other practice location 2

8410 Datapoint Dr Fl 3
San Antonio, TX 78229-3220
Phone (210) 949-8900

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

State licenses

LicenseStateTypeSpecialty
DN122735GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1801548714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2847 HENDERSON MILL ROAD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2847 HENDERSON MILL ROAD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "678-602-0082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 John Wesley Gilbert Drive",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120001",
            "country_code": "US",
            "telephone_number": "706-721-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8410 Datapoint Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293220",
            "country_code": "US",
            "telephone_number": "210-949-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLESSNER",
        "first_name": "CAROLINE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2023-06-25",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.