Latisha Opal Glass, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901019115 Issued in MI

Practice address

131 Columbia Ave E
Battle Creek, MI 49015-3788

Phone

(269) 963-9670

Fax

(269) 963-9672

NPI assigned

Apr 5, 2006

Sex

Female

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael Glass Family and Cosmetic Dentry

  • Dentist
  • Battle Creek, MI
  • NPI 1366764946
  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1972565935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COLUMBIA AVE E",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490153788",
            "telephone_number": "269-963-9670",
            "fax_number": "269-963-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 COLUMBIA AVE E",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490153788",
            "telephone_number": "269-963-9670",
            "fax_number": "269-963-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "LATISHA",
        "middle_name": "OPAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4766214",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry Gillette, MSW
• Robin Y Gills, MA, LPC, CTP -E
• Chrisann Ginnebaugh
• Dominique Marie Giroux, DTLLP
• GL Momentum PLLC
• Michael Eugene Glass, DDS
• Debra Laprad Gleeson, PH.D.
• Kim Jeffrey Gloystein, MD
• Amy Lynn Goff, LPN
• Tracy L Gogan, L.M.S.W., A.C.S.W.

• Dentist in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.