Glenn W Bickert, DMD

Individual provider Active NPI Prosthodontics · Laguna Woods, CA

NPI 1992922447 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992922447
Entity type
Individual (NPI type 1)
Primary specialty
Prosthodontics 1223P0700X
License
27236 (CA)
Practice address
25261 Paseo de Valencia
Suite 2
Laguna Woods, CA 92637-4966
Phone
(949) 951-7988
Fax
(949) 581-5227
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27236CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 27236 CA Yes

Addresses

Primary practice location

25261 Paseo de Valencia
Suite 2
Laguna Woods, CA 92637-4966

Mailing address

21611 Midcrest Dr
Lake Forest, CA 92630-6584
Phone (949) 400-6923

Other names

  • Dr. G W Bickert Professional name

Other providers in Laguna Woods, CA

All providers in Laguna Woods, CA · Prosthodontics in California

Sources for this page

Verify at the official NPI Registry.