NPIMap

Organization Active NPI

Glenn Family Dentistry, Professional LLC

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1942477153
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3462 Issued in CO
Legal business name
GLENN FAMILY DENTISTRY, PROFESSIONAL LLC
Practice address
3600 S Beeler St
Suite 120
Denver, CO 80237-1801
Phone
(303) 779-2592
Fax
(303) 779-2522
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Dewayne Lee Glenn, DDSNPI 1710973813
Title
Owner/Dentist
Phone
(303) 779-2592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3462 CO Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9518 CO

Addresses

Primary practice location

3600 S Beeler St
Suite 120
Denver, CO 80237-1801

Mailing address

3600 S Beeler St
Suite 120
Denver, CO 80237-1801
Phone (303) 779-2592

National Provider Directory

National Provider Directory

Locations

3600 S Beeler St
Ste 120
Denver, CO 80237
Phone (303) 779-2592

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1942477153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 S BEELER ST",
            "address_2": "SUITE 120",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802371801",
            "telephone_number": "303-779-2592",
            "fax_number": "303-779-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S BEELER ST",
            "address_2": "SUITE 120",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802371801",
            "telephone_number": "303-779-2592",
            "fax_number": "303-779-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN FAMILY DENTISTRY, PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "DEWAYNE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "303-779-2592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "3462",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.