Christian Michael Glackin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107363 Issued in CA

Practice address

7300 Girard Ave Ste 206
La Jolla, CA 92037-5138

Phone

(858) 454-4114

NPI assigned

Jul 7, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Grey Cunningham, D.D.S., Apc

  dba Cosmetic & Implant Dentistry of La Jolla

  • General Practice Dentistry
  • La Jolla, CA
  • NPI 1508611492
  NPD
• Paul Fjeldsted DDS Inc

  • Dental Clinic/Center
  • La Mesa, CA
  • NPI 1730644170
  NPD (past)
• Thomas J. Olinger Apc

  • Dentist
  • La Mesa, CA
  • NPI 1659402394
  NPD (past)

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1982275319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 GIRARD AVE STE 206",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375138",
            "telephone_number": "858-454-4114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8375 University Ave",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919429342",
            "country_code": "US",
            "telephone_number": "619-469-2902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLACKIN",
        "first_name": "CHRISTIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kenneth Gilson, M.D., PH.D.
• Farah Giovannelli, PSYD
• Alexander Serge Giritsky, MD
• Lindsey Giunta, PSYD
• Daniel Given, M.D.
• Daniel Scott Glasser
• James William Glen, DDS
• Tara Jackson Glenn, MD
• Samuel R. Glickman, M.D.
• Danielle Kukene Glorioso, LCSW

• General Practice Dentistry in La Jolla, CA
• Providers in La Jolla, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.