GLEN D. THOMPSON (NPI# 1417967936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417967936 |
| Entity Type | Individual |
| Full Name | GLEN D. THOMPSON |
| Credential | DMD |
| Practice Address |
320 E Armstrong Ave Peoria IL 61603-3172 |
| Mailing Address |
12719 Locust Rd Tremont IL 61568-9036 |
| Practice Telephone | 3093600495 |
| Mailing Telephone | 3099253343 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629299268 | Glen Thompson IIi | Specialist/Technologist, Other | 138 Raven Dr, Berea, KY 40403 | 2007-05-01 |
| 1073630778 | Glen Alan Thompson | Pharmacist | 1515 6th Ave South, Cooper Green Hospital, Birmingham, AL 35233 | 2007-03-26 |
| Street Address |
320 E ARMSTRONG AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487639118 | Constance M Freidinger | Physician Assistant | 320 E Armstrong Ave, Peoria, IL 61603 | 2005-12-15 |
| 1023679180 | Thien An Vu | Dentist | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2019-06-27 |
| 1356900419 | Samer Sabbagh | Dentist | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2019-06-11 |
| 1790256303 | Jennifer Lee Kolettis | Nurse Practitioner | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2018-12-07 |
| 1952896417 | Shawn Seok-hun Jung | Dentist | 320 E Armstrong Ave, Peoria, IL 61603 | 2018-06-27 |
| 1992290456 | Mariam Bawany | Dentist | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2018-06-27 |
| 1982199444 | Hardik K Patel | Dentist | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2018-06-27 |
| 1508351065 | Delna Skariah | Dentist | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2018-06-27 |
| 1841726742 | Ashley Renee Droege | Physician Assistant | 320 E Armstrong Ave, Peoria, IL 61603 | 2017-05-11 |
| 1164888483 | Osf Saint Francis Medical Center Gpr Program | Dentist | 320 E Armstrong Ave, Peoria, IL 61603-3172 | 2016-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530187 | Core Family Dental, LLC | Dentist | 13460 N 94th Dr Ste K4, Peoria, AZ 85381-4249 | 2020-05-24 |
| 1982248084 | Westbrook Dental Center, P.a. | Dentist | 9276 W Union Hills Dr Ste A, Peoria, AZ 85382-8206 | 2019-10-31 |
| 1699318725 | Mint Dental Care LLC | Dentist | 8258 W Thunderbird Rd Ste 201, Peoria, AZ 85381-4777 | 2019-10-21 |
| 1548822497 | Katherine M Unes | Dentist | 11323 N Pawnee Rd, Peoria, IL 61615-9796 | 2019-07-01 |
| 1992296073 | George S Hariri | Dentist | 7777 W Deer Valley Rd Ste 160, Peoria, AZ 85382-2104 | 2018-05-23 |
| 1619485869 | Thunderbird Dental Studio | Dentist | 9179 W Thunderbird Rd Ste 107, Peoria, AZ 85381-4875 | 2018-01-22 |
| 1588179311 | Dr. Marc C Thevenin Jr. PC | Dentist | 5116 N Big Hollow Rd Ste 101, Peoria, IL 61615-3514 | 2017-12-01 |
| 1629592423 | Jessica Leigh Howard | Dentist | 7966 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4902 | 2017-08-02 |
| 1588193718 | Darren Anderson | Dentist | 28451 N Vistancia Blvd Ste 101, Peoria, AZ 85383-2090 | 2017-06-10 |
| 1962943290 | Optim Dental Peoria-1 LLC | Dentist | 1200 W Main St Ste 9, Peoria, IL 61606-1218 | 2017-03-20 |
| Find all providers in PEORIA | ||||
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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.