Glenn W Bickert, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

27236 Issued in 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

Last updated

Jul 8, 2007By the provider in NPPES

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 names 1

• Dr. G W Bickert Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992922447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21611 MIDCREST DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926306584",
            "telephone_number": "949-400-6923",
            "fax_number": "949-581-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25261 PASEO DE VALENCIA",
            "address_2": "SUITE 2",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926374966",
            "telephone_number": "949-951-7988",
            "fax_number": "949-581-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKERT",
        "first_name": "GLENN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "27236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G",
            "last_name": "BICKERT",
            "middle_name": "W",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Prosthodontics in Laguna Woods, CA
• Providers in Laguna Woods, CA by specialty
• Prosthodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.