Glendale Family Dentistry, PLLC
Dentist in Glendale, AZ. Organization (NPI-2).
NPI number1265618243
StatusActive
Last updated in NPPESJan 22, 2008
Details
- NPI
- 1265618243
- Entity type
- Organization (NPI-2)
- Legal business name
- Glendale Family Dentistry, PLLC
- Organization subpart
- No
- Enumeration date
- Jan 21, 2008
- Last updated
- Jan 22, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D6674 | AZ | Yes |
| 122300000X | Dentist | D6675 | AZ |
Practice location
7448 W Glendale AveSte. 126
Glendale, AZ 85303-2575
Phone 623-930-0060 · Fax 623-930-0667
Mailing address
7448 W Glendale AveSte. 126
Glendale, AZ 85303-2575
Phone 623-930-0060 · Fax 623-930-0667
Authorized official
Glen S Bui
Dentist/Owner
6239300060
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