KENNETH GLENN DDS - NPI 1649854878 - Dentist in Fortuna, CA

Q: What is Kenneth Glenn's NPI number?

The NPI number for Kenneth Glenn is 1649854878. It was assigned to this individual provider in the NPPES registry on May 12, 2021.

Q: What is Kenneth Glenn's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Glenn was last updated on March 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Kenneth Glenn Dds NPPES

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

KENNETH GLENN DDS (NPI 1649854878) is an individual general practice provider in Fortuna, California, licensed in California (109463) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1649854878

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameKENNETH GLENNCredential: DDS

Location Address3750 ROHNERVILLE RDFortuna, CA 95540-3118

Mailing Address11000 Weyburn Dr Apt A723Los Angeles, CA 90024-2832 · (706) 831-4341

Phone(707) 725-6101

Sole ProprietorNo

Enumeration DateMay 12, 2021

Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1649854878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 109463

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3750 ROHNERVILLE RD, Fortuna, CA 95540

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