Active NPI
Glenn Richard Fausz, DDS
- Dentist
- Toledo, OH
National Provider Identifier
1821179573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14661
- Practice address
- 3349 Executive Pky
Suite G Glenn R Fausz DDS Inc
Toledo, OH 43606-5305 - Phone
- (419) 534-4970
- Fax
- (419) 534-4970
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14661 | OH | Primary |
Addresses
Primary practice location
3349 Executive Pky
Suite G Glenn R Fausz DDS Inc
Toledo, OH 43606-5305
Mailing address
3349 Executive Pky
Suite G Glenn R Fausz DDS Inc
Toledo, OH 43606-5305
Phone (419) 534-4970
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14661 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821179573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3349 EXECUTIVE PKY",
"address_2": "SUITE G GLENN R FAUSZ DDS INC",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436065305",
"telephone_number": "419-534-4970",
"fax_number": "419-531-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3349 EXECUTIVE PKY",
"address_2": "SUITE G GLENN R FAUSZ DDS INC",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436065305",
"telephone_number": "419-534-4970",
"fax_number": "419-534-4970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAUSZ",
"first_name": "GLENN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "14661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.