GLENN A NATHAN DDS NPI 1336220128

NPI Information

NPI: 1336220128
Provider Name: GLENN A NATHAN, DDS
Classification: Dentist - 1223S0112X
Specialization: Oral and Maxillofacial Surgery
Entity Type: Individual
PECOS Registration: Yes
Address: 6201 GREENBELT ROAD
SUITE M-1
COLLEGE PARK, MD
ZIP 20740
Phone: (301) 345-7007

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NPI Details

Glenn A Nathan, DDS is an oral and maxillofacial surgery dentist in College Park, MD. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Glenn A Nathan, DDS NPI is 1336220128. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6201 GREENBELT ROAD
SUITE M-1
COLLEGE PARK, MD
ZIP 20740
Phone: (301) 345-7007
Fax: (301) 345-5288

The NPI 1336220128 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 10/18/2006 and was last updated on 9/26/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	9161	MARYLAND	Yes
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	DEN5167	DISTRICT OF COLUMBIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	T31248	MEDICARE UPIN
2	G01526MO1	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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