A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
1223G0001X | |||
Dentist |
122300000X | |||
Endodontics |
1223E0200X | |||
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) | |
Orthodontics and Dentofacial Orthopedics |
1223X0400X | |||
Pediatric Dentistry |
1223P0221X | |||
Periodontics |
1223P0300X | |||
Prosthodontics |
1223P0700X | |||
Sleep Disorder Diagnostic |
261QS1200X |
| NPI # | 1104553478 |
| LBN Legal business name | GLISTEN DENTAL LLC |
| Authorized official | REVAN DAWOOD - (DENTIST) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/05/2022 |
| Last updated | 06/08/2024 - More than a year ago |
| Identifiers | n/a |
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