DR. MICHAEL JOHN GLIDDON (NPI# 1285604553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285604553 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JOHN GLIDDON |
| Credential | DDS |
| Practice Address |
3617 W. Gore Blvd. Suite B Lawton OK 73505-6373 |
| Mailing Address |
3617 W. Gore Blvd Suite B Lawton OK 73505-6373 |
| Practice Telephone | 5803570888 |
| Practice Fax Number | 5802481860 |
| Mailing Telephone | 5803570888 |
| Mailing Fax Number | 5802481860 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2012-03-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
160 | OK | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
19422 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200345180A | 05 |
| Street Address |
3617 W. GORE BLVD. SUITE B |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-6373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740572601 | Lauren Lunday | Dentist | 3617 W Gore Blvd Ste B, Lawton, OK 73505-6373 | 2011-05-11 |
| 1265735724 | Michael J. Gliddon Dba Live Oak Oral Surgery | Dentist | 1415 Nw 33rd St, Lawton, OK 73505-3806 | 2010-12-06 |
| 1609006345 | Southwest Oral & Maxillofacial Surgery | Dentist | 916 Sw 38th St Ste A, Lawton, OK 73505-7005 | 2009-07-15 |
| 1114918844 | Perry L Brooks | Dentist | 3617 W. Gore Blvd., Suite B, Lawton, OK 73505 | 2005-11-02 |
| 1134596166 | Souhwest Oral Surgery PC | Dentist | 3617 W Gore Blvd Ste B, Lawton, OK 73505-6373 | 2015-08-25 |
| 1861759508 | David M Lindley, Dds, Inc | Dentist | 1315 W Gore Blvd, Lawton, OK 73501-3605 | 2012-04-19 |
| 1366672552 | Lawton Surgical and Cosmetic Arts | Dentist | 3617 W Gore Blvd, Suite B, Lawton, OK 73505-6373 | 2009-07-22 |
| 1912071739 | Cloyce Wayne Littlefield Jr. | Dentist | 3617 W Gore Blvd, Suite B, Lawton, OK 73505 | 2006-11-20 |
| 1952404576 | David Michael Lindley | Dentist | 1315 W Gore Blvd, Lawton, OK 73501 | 2006-09-07 |
| 1164534830 | Paul Wood | Dentist | 916 Sw 38th St, Suite A, Lawton, OK 73505-7005 | 2006-08-31 |
| Find all providers in LAWTON | ||||
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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.