C Douglas Fowler DDS Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

19067 Issued in CA

Legal business name

C DOUGLAS FOWLER DDS INC

Practice address

6850 Brockton Avenue
Suite 103
Riverside, CA 92506-3826

Phone

(951) 686-5301

Fax

(951) 686-4375

NPI assigned

Mar 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles Douglas Fowler, DDS

Title

President

Phone

(951) 686-5301

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Woo Daniel Han, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Riverside, CA
  • NPI 1447494059
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013035153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 BROCKTON AVENUE",
            "address_2": "SUITE 103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063826",
            "telephone_number": "951-686-5301",
            "fax_number": "951-686-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 BROCKTON AVENUE",
            "address_2": "SUITE 103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063826",
            "telephone_number": "951-686-5301",
            "fax_number": "951-686-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C DOUGLAS FOWLER DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-686-5301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "19067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Riverside, CA
• Providers in Riverside, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.