Glen Tistaert, DDS
NPI 1184841207 · General Practice Dentistry · Santa Monica, CA
Enrolled with Medicare as Order and Referring Only - Oral Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Glen Tistaert, DDS is a General Practice Dentistry provider in Santa Monica, CA (NPI 1184841207).
Provider details
- NPI number
- 1184841207
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 18421 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
Mailing address
Registry dates
- Enumerated
- 2007-04-19
- Last updated
- 2007-07-08
Frequently asked questions
- What is Glen Tistaert's NPI number?
- Glen Tistaert's National Provider Identifier (NPI) is 1184841207, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Glen Tistaert's specialty?
- Glen Tistaert is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Glen Tistaert located?
- Glen Tistaert's practice location on file with NPPES is 1333 7th St, Santa Monica, CA 90401-1607.
- What is Glen Tistaert's phone number?
- The practice phone number listed in the NPPES registry for Glen Tistaert is (310) 394-2661.
- Does Glen Tistaert accept Medicare?
- Glen Tistaert is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Glen Tistaert's NPI active?
- Yes — Glen Tistaert's NPI (1184841207) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.