Linda Ann Glick, C.D.A. EFDA

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

2013015015 Issued in MO

Practice address

5047 Virginia Ave.
Fort Leonard Wood, MO 65473-1317

Phone

(573) 596-0408

Fax

(573) 596-0314

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1821544438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 VIRGINIA AVE.",
            "address_2": "HARPER DENTAL CLINIC BLD 500",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654731317",
            "telephone_number": "573-596-0408",
            "fax_number": "573-596-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 VIRGINIA AVE.",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654731317",
            "telephone_number": "573-596-0408",
            "fax_number": "573-596-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "LINDA",
        "middle_name": "ANN",
        "credential": "C.D.A. EFDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2013015015",
            "primary": true
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2013015016",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2013015017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dia Gerdes
• Angela Gillespie
• Alexander Gillette, DPT
• Jean A Gilstrap, M.D.
• Kayette Marie Glass, PSY.D.
• Glwach
• Michael Steven Godat, PA-C
• Jennifer Lynn Gonzalez, LSW
• Daniel A Good, PHD
• Richard Doyle Gordon Jr., ARNP

• Dental Assistant in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Dental Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.