1. Home
  2. Directory
  3. Texas
  4. Grand Prairie
  5. Dentist
  6. NPI Profile

DR. RUSSELL EUGENE GLENN JR. DDO
NPI 1801904321
Dentist in Grand Prairie, TX

Active since August 25, 2006Opted out of Medicare · through Feb 12, 2028
573 W PIONEER PKWY, GRAND PRAIRIE, TX 75051(972) 642-5775(972) 642-1251 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Russell Eugene Glenn Jr. Ddo NPPES

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

DR. RUSSELL EUGENE GLENN JR. DDO (NPI 1801904321) is an individual dentist in Grand Prairie, Texas, licensed in Texas (16051) and active in the NPI registry since August 2006. He has opted out of Medicare through February 12, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1801904321
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. RUSSELL EUGENE GLENN JR.Credential: DDO
Location Address573 W PIONEER PKWYGrand Prairie, TX 75051
Mailing Address573 W Pioneer PkwyGrand Prairie, TX 75051 · (972) 642-5775 · Fax (972) 642-1251
Phone(972) 642-5775
Fax(972) 642-1251
Sole ProprietorYes
Enumeration DateAugust 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1801904321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in TX · 16051
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
573 W PIONEER PKWY, Grand Prairie, TX 75051
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Russell Eugene Glenn Jr. Ddo has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 12, 2016 through February 12, 2028.

Opt-Out Effective DateFebruary 12, 2016
Opt-Out In Effect ThroughFebruary 12, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75051 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
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.

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 Russell Glenn's NPI number?

The NPI number for Russell Glenn is 1801904321. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Russell Glenn located?

Russell Glenn practices at 573 W Pioneer Pkwy, Grand Prairie, TX 75051. The listed phone number is (972) 642-5775.

What is Russell Glenn's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Russell Glenn enrolled in Medicare?

No. Russell Glenn has opted out of Medicare through February 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Russell Glenn 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.