Provider Demographics
NPI:1215140702
Name:GLINATSIS, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GLINATSIS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:GLINATSIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:326 NORTHCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1345
Mailing Address - Country:US
Mailing Address - Phone:440-333-4152
Mailing Address - Fax:
Practice Address - Street 1:37713 VINE ST
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-6220
Practice Address - Country:US
Practice Address - Phone:440-951-9240
Practice Address - Fax:440-951-9242
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH192541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice