Glen B Moyer, D. D. S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016-0000773 Issued in VT

Practice address

564 Route 2
Suite 2
South Hero, VT 05486-4307

Phone

(802) 372-3737

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952346694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TOWNLINE RD",
            "city": "GRAND ISLE",
            "state": "VT",
            "postal_code": "054582563",
            "telephone_number": "802-372-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 ROUTE 2",
            "address_2": "SUITE 2",
            "city": "SOUTH HERO",
            "state": "VT",
            "postal_code": "054864307",
            "telephone_number": "802-372-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "GLEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016-0000773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00002404",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in South Hero, VT
• Providers in South Hero, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.