NPIMap

Organization Active NPI

West Dover Dental, LLC

  • Dentist
  • Dover, DE
National Provider Identifier
1811352826
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G1-0000965 Issued in DE
Legal business name
WEST DOVER DENTAL, LLC
Practice address
2 Greentree Drive
Dover, DE 19904
Phone
(302) 734-0330
NPI assigned
Dec 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Dr. Glen Goleburn, D.M.D.
Title
General Dentist
Phone
(302) 734-0330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X G1-0000965 DE Primary

Addresses

Primary practice location

2 Greentree Drive
Dover, DE 19904

Mailing address

2 Greentree Drive
Dover, DE 19904

National Provider Directory

National Provider Directory

Locations

2 Greentree Dr
Dover, DE 19904
Phone (302) 734-0330

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1811352826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENTREE DRIVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GREENTREE DRIVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19904",
            "telephone_number": "302-734-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST DOVER DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "GOLEBURN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "302-734-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0000965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.