Individual provider Active NPI

Glenn A Noble, DDS

  • Dentist
  • Tryon, NC
National Provider Identifier
1871550442
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9912 Issued in NC
Practice address
70 Depot St
Tryon, NC 28782-3358
Phone
(828) 859-5839
Fax
(828) 858-5502
NPI assigned
Apr 27, 2006
Last updated
Jan 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9912 NC Primary

Addresses

Primary practice location

70 Depot St
Tryon, NC 28782-3358

Mailing address

70 Depot St
Tryon, NC 28782-3358
Phone (828) 859-5839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160212000687 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739483660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1871550442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DEPOT ST",
            "city": "TRYON",
            "state": "NC",
            "postal_code": "287823358",
            "telephone_number": "828-859-5839",
            "fax_number": "828-858-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DEPOT ST",
            "city": "TRYON",
            "state": "NC",
            "postal_code": "287823358",
            "telephone_number": "828-859-5839",
            "fax_number": "828-858-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "GLENN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tryon, NC

Sources for this page

Verify at the official NPI Registry.