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Provider Information for 1760097034

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. HANNAH GLAZUNOV DMD

Gender: FEMALE

Individual NPI: 1760097034

Calendar   Last Updated:  2020-09-13
  Certification Date:  2020-09-13

Details

Name Value
NPI 1760097034
Enumeration Date 2020-09-13
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4970 S LANDING DR UNIT 302
PORTLAND, OR 97239-5900
United States

Phone: 360-631-8132 | Fax:
View Map External Link
Primary Practice Address 4970 S LANDING DR UNIT 302
PORTLAND, OR 97239-5900
United States

Phone: 360-631-8132 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice OR D11325