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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. GLENN JAMES JIVIDEN JR., D.D.S.

Active

DR. GLENN JAMES JIVIDEN JR., D.D.S. is a Periodontology healthcare provider located in DAYTON, Ohio. NPI 1750591590 is currently active in the NPPES registry. Verify at CMS.

Periodontology · DAYTON, OH

Registration Details

NPI Number
1750591590
Provider Type
Individual
Gender
Male
NPI Issued
May 23, 2007 (19.257248226091 yrs)
Last Updated
Jul 8, 2007
License
30-01-8124 (OH)

Practice Information

Address
4300 LINDEN AVE
DAYTON, OH, 454323022
Browse OH providers · Browse ZIP 45432
Phone
9372590072
Fax
9372590383
Primary Specialty
Periodontology
1223P0300X

Other Periodontology Providers in DAYTON, OH

Name Credential NPI
DR. ROBERT T JENSEN DDS 1255376281
MARK HEBEISH 1922417229
RASHEE GOYAL MANNAVA DMD 1508266552
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.