Healthcare Provider Details

I. General information

NPI: 1639812761
Provider Name (Legal Business Name): GLAIRE O. DELANCY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 W BURNSIDE AVE
BRONX NY
10453-4015
US

IV. Provider business mailing address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

V. Phone/Fax

Practice location:
  • Phone: 718-483-1270
  • Fax:
Mailing address:
  • Phone: 410-870-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number063790-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: