Active NPI
Jeffrey L Glassley, DDS
- General Practice Dentistry
- Fort Wayne, IN
National Provider Identifier
1942415997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7731
- Practice address
- 5108 N Clinton St
Fort Wayne, IN 46825-5720 - Phone
- (260) 482-1551
- NPI assigned
- May 13, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 7731 | IN | Primary |
Addresses
Primary practice location
5108 N Clinton St
Fort Wayne, IN 46825-5720
Mailing address
5108 N Clinton St
Fort Wayne, IN 46825-5720
Phone (260) 482-1551
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 |
|---|---|---|---|
| 7731 | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glassley & Marr Dental Group, P.C. | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Fort Wayne, IN
- NPI 1275603508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942415997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5108 N CLINTON ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468255720",
"telephone_number": "260-482-1551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5108 N CLINTON ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468255720",
"telephone_number": "260-482-1551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSLEY",
"first_name": "JEFFREY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "7731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.