DR. GLENN TAYLOR MATTLAGE DDS
NPI 1184603243
Dentist - Periodontics in Lubbock, TX

Active since January 17, 2006PECOS Enrolled
4415 66TH ST, SUITE 112, LUBBOCK, TX 79414(806) 797-1275 Get Directions Write a Review

NPPES record last updated: August 26, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Glenn Taylor Mattlage Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLENN TAYLOR MATTLAGE DDS (NPI 1184603243) is an individual periodontics provider in Lubbock, Texas, licensed in New Mexico (DD1382) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184603243
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. GLENN TAYLOR MATTLAGECredential: DDS
Location Address4415 66TH ST, SUITE 112Lubbock, TX 79414-4809
Mailing Address4415 66th St, Suite 112Lubbock, TX 79414-4809 · (806) 797-1275
Sole ProprietorYes
Enumeration DateJanuary 17, 2006
Last NPPES UpdateAugust 26, 2014
NPI 1184603243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Licenses Licensed in NM · DD1382 Licensed in TX · 12592
Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

4415 66TH ST, Lubbock, TX 79414

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Glenn Taylor Mattlage Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79414 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
4415 66TH ST, STE 112
LUBBOCK, TX 79414
Dentist (General Practice)
4415 66TH ST, STE 112
LUBBOCK, TX 79414
Dentist (General Practice)
4415 66TH ST, SUITE 110
LUBBOCK, TX 79414
Dentist (Periodontics)
4415 66TH ST, SUITE 112
LUBBOCK, TX 79414

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184603243, enumerated as an "individual" on January 17, 2006.

The provider is located at 4415 66TH ST SUITE 112 LUBBOCK, TX 79414 and the phone number is (806) 797-1275.

Dentist with taxonomy code 1223P0300X and a focus in Periodontics.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama. Please consult your insurance carrier or call the provider to verify.