GLEN M IMAMURA (NPI# 1306835053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306835053 |
| Entity Type | Individual |
| Full Name | GLEN M IMAMURA |
| Credential | DDS |
| Practice Address |
13001 Ebenezer Chapel Dr Clarksburg MD 20871-4323 |
| Practice Telephone | 3015154281 |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
IL | Dental Providers |
| Street Address |
13001 EBENEZER CHAPEL DR |
| City | CLARKSBURG |
| State | MD |
| Zip Code | 20871-4323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366097578 | Shelah Maul | Speech-Language Pathologist | Clarksburg Elementary School, 13530 Redgrave Place, Clarksburg, MD 20871 | 2019-08-05 |
| 1013401769 | Thin Phyu Bur | Social Worker | 13446 Dutrow Dr, Clarksburg, MD 20871 | 2018-06-17 |
| 1750754925 | Milankumar Maheshbhai Patel | Physical Therapist | 23923 Basil Park Circle, Clarksburg, MD 20871 | 2015-11-09 |
| 1093142796 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 22700 Sweet Shrub Drive, Clarksburg, MD 20871 | 2013-09-26 |
| 1932493046 | Chidinma Ebele | Case Management | 23447 Tailor Shop Pl, Clarksburg, MD 20871 | 2011-06-06 |
| 1396036455 | Reliance Home Care | Home Health | 12615 Blue Sky Drive, Clarksburg, MD 20871 | 2011-04-25 |
| 1063721629 | Clarksburg Medical Center Inc | Ophthalmology | 22616 Gateway Center Dr Ste 600a, Clarksburg, MD 20871 | 2010-09-30 |
| 1548440787 | Patricia J. Tucker | Social Worker | 21925 Frederick Rd, Clarksburg, MD 20871 | 2007-11-05 |
| 1316439078 | Clarksburg Dermatology and Skincare LLC | Nurse Practitioner | 23202 Brewers Tavern Way, Clarksburg, MD 20871 | 2018-05-30 |
| 1487954509 | Sean Park | Pharmacist | 7025 Brookville Rd, Chevy Chase, MD 20871 | 2010-10-22 |
| Find all providers in zip 20871 | ||||
| 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 |
|---|---|---|---|---|
| 1356420186 | Peter James Pangilinan | Dentist | 700 W Pike St, Suite 100, Clarksburg, WV 26301-2696 | 2006-11-03 |
| 1265511091 | David A Lattanzi | Dentist | 700 West Pike Street, Suite 100, Clarksburg, WV 26301 | 2006-11-03 |
| 1235544958 | Gino A Gismondi Dds Pllc | Dentist | 700 W Pike St, Suite 100, Clarksburg, WV 26301-2696 | 2014-06-23 |
| 1336238369 | Robert Warren Graves | Dentist | One Medical Center Dr., Clarksburg, WV 26301 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508490707 | Carl Ruderman Dds LLC | Dentist | 6309 Baltimore Ave Ste 202, Riverdale, MD 20737-1059 | 2020-02-26 |
| 1740810845 | Akeso Columbia Office LLC | Dentist | 6798 Oak Hall Ln Ste A-1, Columbia, MD 21045-4892 | 2020-01-17 |
| 1245742741 | Akeso Orafacial Maxillary Surgery | Dentist | 7544 Belair Road, Nottingham, MD 21236 | 2017-10-25 |
| 1710436407 | Central Maryland Oral and Facial Surgical Arts of Clarksville, LLC | Dentist | 12431 Clarksville Pike, Route 108, Clarksville, MD 21029 | 2016-09-23 |
| 1356726301 | Jak LLC | Dentist | 352 Thompson Creek Mall, Stevensville, MD 21666-2500 | 2015-07-20 |
| 1548661614 | Ib Dental II, P.C. | Dentist | 30a Audrey Lane, Oxon Hill, MD 20745-1301 | 2014-09-09 |
| 1457764052 | Xun Joy Chen | Dentist | 15005 Shady Grove Rd Ste 420, Rockville, MD 20850-6321 | 2014-06-11 |
| 1164848370 | Maryland Oral Surgery Associates of Frederick, LLC | Dentist | 161 Thomas Johnson Dr Ste 295, Frederick, MD 21702-4314 | 2014-03-12 |
| 1013345511 | The Oral Surgery Center At Mitchellville | Dentist | 12164 Central Ave Ste 224, Mitchellville, MD 20721-1903 | 2013-10-17 |
| 1992142806 | Nkemakonam Egolum | Dentist | 4175 N Hanson Ct Ste 200, Bowie, MD 20716 | 2013-05-31 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSBURG |
| Zip Code | 20871 |
Please comment or provide details below to improve the information on GLEN M IMAMURA.
| 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.