Jividen, Glenn James

Jividen, Glenn James is an individual health care provider with primary practice located at 4300 Linden Ave , Dayton OH 45432-3022. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Jividen, Glenn James can be contacted via phone (937) 259-0072.

Contact Information

Primary practice address
4300 Linden Ave Dayton OH 45432-3022
Phone: (937) 259-0072
Fax: (937) 259-0383
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 30-01-8124 Ohio

Profile Details

NPI number 1750591590
LBN Legal business name Jividen, Glenn James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1750591590 NPPES
Ohio Other 30-01-8124 STATE DENTAL LICENSE

Popular Providers