Individual
R GLENN OWENS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4356 4 BONNEY ROAD, SUITE 101, VIRGINIA BEACH, VA 23452-1200
(757) 340-7000
(757) 498-6498
Mailing address
4356 4 BONNEY ROAD, SUITE 101, VIRGINIA BEACH, VA 23452-1200
(757) 340-7000
(757) 498-6498
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401003151
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
326098
ANTHEM BCBS
VA
01
—
547859
UNITED CONCORDIA
VA
05
—
7900104
—
VA
Enumeration date
10/05/2006
Last updated
05/17/2026
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