IndividualActive
Glenn Mattlage, DDS
NPI 1184603243 · Periodontics · Lubbock, TX
Provider details
- NPI number
- 1184603243
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- DD1382 (NM)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4415 66th St
Suite 112
Lubbock, TX 79414-4809
Phone: (806) 797-1275
Street-level locationGet directions
Mailing address
4415 66th St
Lubbock, TX 79414-4809
Registry dates
- Enumerated
- 2006-01-17
- Last updated
- 2014-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.