Active NPI
Glen W Cole, D.D.S.
- General Practice Dentistry
- Philadelphia, PA
National Provider Identifier
1871897983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS016907L
- Practice address
- 29 W Highland Ave
Philadelphia, PA 19118-3309 - Phone
- (215) 242-1662
- Fax
- (215) 247-0234
- NPI assigned
- Jan 4, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS016907L | PA | Primary |
Addresses
Primary practice location
29 W Highland Ave
Philadelphia, PA 19118-3309
Mailing address
29 W Highland Ave
Philadelphia, PA 19118-3309
Phone (215) 242-1662
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS016907L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788048000000",
"number": "1871897983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 W HIGHLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191183309",
"telephone_number": "215-242-1662",
"fax_number": "215-247-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 W HIGHLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191183309",
"telephone_number": "215-242-1662",
"fax_number": "215-247-0234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "GLEN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-04",
"last_updated": "2026-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS016907L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.