Provider Demographics
NPI:1477832160
Name:JANET GLENN DDS MAGD
Entity Type:Organization
Organization Name:JANET GLENN DDS MAGD
Other - Org Name:GENTLE DENTISTRY OF LAS COLINAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:C
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MAGD
Authorized Official - Phone:972-594-0022
Mailing Address - Street 1:6550 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2480
Mailing Address - Country:US
Mailing Address - Phone:972-594-0022
Mailing Address - Fax:972-409-1000
Practice Address - Street 1:6550 SIERRA DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2480
Practice Address - Country:US
Practice Address - Phone:972-594-0022
Practice Address - Fax:972-409-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14637122300000X
TX16096122300000X
TX25389122300000X
TX14982122300000X
TX196771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty