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Dr. Glenn James Jividen JR., DDS
Periodontist in Dayton, Ohio
NPI 1750591590

Glenn James Jividen JR. is a Periodontist based in Dayton, OH and is specialized in Periodontics. Glenn James Jividen JR. practices in Dayton, OH and has the professional credentials of DDS. The NPI Number for Glenn James Jividen JR. is 1750591590 and holds a License No. 30-01-8124 (Ohio).

The current practice location address for Glenn James Jividen JR. is 4300 Linden Ave, Dayton, OH and can be reached out via phone at 937-259-0072 and via fax at 937-259-0383.

Location: 4300 Linden Ave, Dayton, OH, 45432-3022
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750591590
Provider Name
Glenn James Jividen JR.
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
4300 Linden Ave, Dayton, OH, 45432-3022
Phone Number
937-259-0072
Fax Number
937-259-0383
Provider Enumeration Date
05/23/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30-01-8124 01 OH STATE DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
4300 Linden Ave
City
Dayton
State
Ohio
Zip
45432-3022
Phone Number
937-259-0072
Fax Number
937-259-0383
person
Provider Business Mailing Address Details
Address
4300 Linden Ave
City
Dayton
State
Ohio
Zip
45432-3022
Phone Number
937-259-0072
Fax Number
937-259-0383
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
30-01-8124 (Ohio)
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.
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