Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Glen A. Tistaert, DDS

Individual provider General Practice Dentistry · NPI 1184841207

Dr. Glen A. Tistaert, DDS is a General Practice Dentistry in Santa Monica, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1333 7th St
Santa Monica, CA 90401-1607
Phone: (310) 394-2661
Fax: (310) 450-9451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 18421 (CA)

Record details

NPI number1184841207
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedApril 19, 2007
Last updated in NPPESJuly 8, 2007

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