Glenn L Sands, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

91-1452679922 Issued in UT

Practice address

1770 Fort Union Blvd Ste 201
Salt Lake City, UT 84121-2878

Phone

(801) 942-0610

Fax

(801) 942-0706

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• 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.

• Knoxville Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Knoxville, TN
  • NPI 1649879271
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1992809339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E FT UNION BLVD",
            "address_2": "STE 201",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841212878",
            "telephone_number": "801-733-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 FORT UNION BLVD STE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212878",
            "telephone_number": "801-942-0610",
            "fax_number": "801-942-0706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2944 Tazewell Pike Ste 1",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379181990",
            "country_code": "US",
            "telephone_number": "865-522-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDS",
        "first_name": "GLENN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "0000011034",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "91-1452679922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Sandoval
• Michala Sandoval
• Rachel Sandoval, SUDCI
• Roberto Carlos Sandoval
• Allison Sands
• Debra Lynn Sandt
• Jenifer L Sandvig, MD
• Suzanne Sandwick, P.T.
• Megan Sandy, PA-C
• Grant William Sanford

• All providers in Salt Lake City, UT
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.