Individual provider Active NPI

William Eric Gladden, D.M.D.

  • General Practice Dentistry
  • Savannah, GA
National Provider Identifier
1922183144
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12535 Issued in GA
Practice address
10010 Abercorn St
Suite 3
Savannah, GA 31406-4560
Phone
(912) 925-8660
Fax
(912) 925-8665
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12535 GA Primary

Addresses

Primary practice location

10010 Abercorn St
Suite 3
Savannah, GA 31406-4560

Mailing address

10010 Abercorn St
Suite 3
Savannah, GA 31406-4560
Phone (912) 925-8660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150420001250 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103144381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12535GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922183144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 ABERCORN ST",
            "address_2": "SUITE 3",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064560",
            "telephone_number": "912-925-8660",
            "fax_number": "912-925-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 ABERCORN ST",
            "address_2": "SUITE 3",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064560",
            "telephone_number": "912-925-8660",
            "fax_number": "912-925-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADDEN",
        "first_name": "WILLIAM",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "12535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.