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Deactivated NPI 1194099135 Deactivated / Inactive NPI Male Practitioner

Glen Edwin Casper , LD

Denturist • North Bend, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Glen Casper has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 07, 2012
NPI Deactivation Date June 14, 2021
Total Practice Duration ~9 Years of Practice (2012 – 2021)

Professional Overview & Biography Verified Profile Summary

Glen Casper, LD was a registered Denturist practicing in North Bend, OR. Throughout an active medical career spanning 9 years, Glen Casper provided care at the practice location at 3436 BROADWAY ST until profile deactivation on 2021-06-14.

Practice Location & Contact Primary Location

Practice Address

3436 Broadway St

North Bend, OR 974591202

Telephone 5417566313
Fax 5418082722

Specialty Benchmarks & Practice Insights

Comparative analytics for Denturist in North Bend, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in North Bend, OR (139 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

Denturist Primary Specialty

NUCC Taxonomy Code: 122400000X

State License OR DT-DO 364493

A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated June 14, 2021

Record deactivated on June 14, 2021

NPI Profile Active March 07, 2012

NPI status registered as active in NPPES database

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Updated Practice Location March 07, 2012

Registered at 3436 BROADWAY ST, NORTH BEND, OR 974591202 (Tel: 5417566313)

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Updated Business Mailing Address March 07, 2012

Registered at 3436 BROADWAY ST, NORTH BEND, OR 974591202 (Tel: 5417566313)

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Provider Name / Credentials Updated March 07, 2012

Recorded as GLEN CASPER, LD

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2012

Denturist (License #DT-DO 364493 in OR)

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Initial NPI Registration & Enumeration March 07, 2012

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: 1194099135
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 07, 2012
Last Update: March 07, 2012
Deactivation Date: June 14, 2021

Mailing Address

3436 Broadway St

North Bend, OR 974591202

Phone: 5417566313

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.