DR. ELLEN JULIENNE GLYNN (NPI# 1023182698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023182698 |
| Entity Type | Individual |
| Full Name | DR. ELLEN JULIENNE GLYNN |
| Credential | DDS MDS |
| Practice Address |
655 Camino De Los Mares Ste 119 San Clemente CA 92673-2809 |
| Practice Telephone | 9494880600 |
| Mailing Telephone | 9494880600 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
41258 | CA | Dental Providers |
| Street Address |
655 CAMINO DE LOS MARES STE 119 |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447445192 | Samuel Sung-jae Lee | Dentist | 511 Calle Malaguena, San Clemente, CA 92672-2357 | 2007-09-06 |
| 1821146416 | Michael John Redmond | Dentist | 181 Avenida Vaquero, Suite C, San Clemente, CA 92672-3600 | 2007-01-08 |
| 1366510695 | Alex Brandon | Dentist | 1001 Avenida Pico Ste I, San Clemente, CA 92673-6956 | 2006-12-04 |
| 1841300910 | Frank Joseph Mogavero | Dentist | 1031 Avenida Pico, Suite 101, San Clemente, CA 92673-6352 | 2006-08-30 |
| 1255584280 | Henken & Kennedy Orthodontic Dental Group | Dentist | 1171 Puerta Del Sol, Suite B, San Clemente, CA 92673-6343 | 2008-11-04 |
| 1295902682 | W. Ronald Redmond Dds Ms Inc. | Dentist | 181 Avenida Vaquero, Suite C, San Clemente, CA 92672-3600 | 2008-05-14 |
| 1528183316 | Edmond Herbert Henken | Dentist | 1171 Puerta Del Sol, Suite B, San Clemente, CA 92673-6343 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091720 | Ellen Im Dds Inc | Dentist | 13422 Pomerado Rd Ste 201, Poway, CA 92064-3548 | 2020-10-21 |
| 1104425370 | Jack Bayraymyan Dental Group Inc. | Dentist | 2621 Zoe Ave Ste A, Huntington Park, CA 90255-4131 | 2020-10-20 |
| 1669071825 | Jack Bayraymyan Dental Group Inc. | Dentist | 418 E Glenoaks Blvd Ste 202, Glendale, CA 91207-2093 | 2020-10-20 |
| 1891394060 | Jack Bayraymyan Dental Group Inc. | Dentist | 600 S Alvarado St Ste 200-201, Los Angeles, CA 90057-3314 | 2020-10-20 |
| 1790391209 | Two Front Corp | Dentist | 2408 Grandview Ave, Venice, CA 90291-4938 | 2020-09-21 |
| 1396358453 | Bridget Powers | Dentist | 1000 Ygnacio Valley Rd, Walnut Creek, CA 94598-1812 | 2020-08-28 |
| 1144832221 | Manjeet Samra Dental Corporation | Dentist | 1700 Mchenry Ave Ste 16b, Modesto, CA 95350-4319 | 2020-08-19 |
| 1154932150 | Jacqueline Morgan Payne | Dentist | 1820 Sonoma Ave Ste 36, Santa Rosa, CA 95405-6617 | 2020-08-12 |
| 1922617802 | Andrew Levin | Dentist | 7891 Talbert Ave # 2, Huntington Beach, CA 92648-8612 | 2020-07-27 |
| 1861001885 | Robert Berger | Dentist | 2529 Via Sanchez, Palos Verdes Estates, CA 90274-2805 | 2020-07-26 |
| Find all providers with the same taxonomy | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.