Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1649854878 Individual Practitioner Male Practitioner

Dr. Kenneth Glenn , DDS

Dentist - General Practice • Fortuna, CA

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Glenn, DDS is a registered healthcare professional specializing in Dentist - General Practice in Fortuna, CA. Practice services are available at 3750 ROHNERVILLE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3750 Rohnerville Rd

Fortuna, CA 955403118

Telephone 7077256101
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fortuna, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
5 Specialists

Practicing in Fortuna, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-03-14
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 109463

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Maureen Frank , FNP

Nurse Practitioner

NPI 1023183969

Family Nurse Practitioner

Angela Murray , PA

Physician Assistant - Medical

NPI 1063746287

Physician Assistant

Mark Mowrey , RN

Registered Nurse

NPI 1134586407

Registered Nurse

NPI 1144867474

Registered Nurse

NPI 1205578663

Doctor of Medicine (M.D.)

Pamela Russ , RN

Registered Nurse

NPI 1215487947

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location March 14, 2025

Registered at 3750 ROHNERVILLE RD, FORTUNA, CA 955403118 (Tel: 7077256101)

👤
Provider Name / Credentials Updated March 14, 2025

Recorded as KENNETH GLENN, DDS

NPI Profile Active May 12, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location May 12, 2021

Registered at 11301 WILSHIRE BLVD, LOS ANGELES, CA 900731003 (Tel: 3104783711)

📍
Updated Business Mailing Address May 12, 2021

Registered at 11000 WEYBURN DR APT A723, LOS ANGELES, CA 900242832 (Tel: 7068314341)

👤
Provider Name / Credentials Updated May 12, 2021

Recorded as KENNETH GLENN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 12, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 12, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649854878
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 12, 2021
Last Update: March 14, 2025
Sole Proprietor: No

Mailing Address

11000 Weyburn Dr Apt A723

Los Angeles, CA 900242832

Phone: 7068314341

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.