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DR. GLENN JAMES JIVIDEN JR. D.D.S.
NPI 1750591590
Dentist - Periodontics in Dayton, OH

Active since May 23, 2007PECOS Enrolled
4300 LINDEN AVE, DAYTON, OH 45432(937) 259-0072(937) 259-0383 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Glenn James Jividen Jr. D.d.s. NPPES

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

DR. GLENN JAMES JIVIDEN JR. D.D.S. (NPI 1750591590) is an individual periodontics provider in Dayton, Ohio, licensed in Ohio (30-01-8124) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750591590
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. GLENN JAMES JIVIDEN JR.Credential: D.D.S.
Location Address4300 LINDEN AVEDayton, OH 45432-3022
Mailing Address4300 Linden AveDayton, OH 45432-3022 · (937) 259-0072 · Fax (937) 259-0383
Phone(937) 259-0072
Fax(937) 259-0383
Sole ProprietorNo
Enumeration DateMay 23, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1750591590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in OH · 30-01-8124
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.
4300 LINDEN AVE, Dayton, OH 45432
Open in Google Maps ↗

Other Identifiers 1

Other30-01-8124OH · State Dental License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Ohio, MedMutual.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 James Jividen Jr. D.d.s. 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 45432 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 2

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

RASHEE GOYAL MANNAVA DMD
Dentist (Periodontics)
4300 LINDEN AVE
DAYTON, OH 45432
Greene County (937) 259-0072
MARK HEBEISH
Dentist (Periodontics)
4300 LINDEN AVE
DAYTON, OH 45432
Greene County (937) 259-0072

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Jividen's NPI number?

The NPI number for Glenn Jividen is 1750591590. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is Glenn Jividen located?

Glenn Jividen practices at 4300 Linden Ave, Dayton, OH 45432. The listed phone number is (937) 259-0072.

What is Glenn Jividen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Glenn Jividen enrolled in Medicare?

Yes. Glenn Jividen is registered in the Medicare PECOS enrollment system.

What insurance does Glenn Jividen accept?

Health plans from Delta Dental of Ohio and MedMutual list Glenn Jividen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glenn Jividen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.