NPIMap

Organization Active NPI

Glade Dental Practice LLC

  • Dental Clinic/Center
  • Reisterstown, MD
National Provider Identifier
1922463488
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
16179 Issued in MD
Legal business name
GLADE DENTAL PRACTICE LLC
Practice address
11710 Reisterstown Rd
201
Reisterstown, MD 21136-3363
Phone
(410) 833-8380
NPI assigned
Dec 28, 2015
Last updated
Dec 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Authorized official

Name
Ketan Ginoya
Title
Manager
Phone
(410) 833-8380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 16179 MD Primary

Addresses

Primary practice location

11710 Reisterstown Rd
201
Reisterstown, MD 21136-3363

Mailing address

11710 Reisterstown Rd
201
Reisterstown, MD 21136-3363
Phone (410) 833-8380

National Provider Directory

National Provider Directory

Locations

11710 Reisterstown Rd
Ste 201
Reisterstown, MD 21136
Phone (410) 833-8380

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1922463488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 REISTERSTOWN RD",
            "address_2": "201",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363363",
            "telephone_number": "410-833-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 REISTERSTOWN RD",
            "address_2": "201",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363363",
            "telephone_number": "410-833-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE DENTAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "GINOYA",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-833-8380"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "16179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.