Adeniji Bowden, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013022A Issued in IN

Practice address

2611 Broadway Ave
Evanston, IL 60201-1501

Phone

(773) 263-6517

NPI assigned

Jul 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Woodlawn Dental Gallery

  • Dentist
  • Chicago, IL
  • NPI 1568838043
  NPD (past)

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1023596228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 BROADWAY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011501",
            "telephone_number": "847-532-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 BROADWAY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011501",
            "telephone_number": "773-263-6517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 E 63rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606372921",
            "country_code": "US",
            "telephone_number": "773-496-5138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "ADENIJI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013022A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Boubouleix, MD
• Justin Boumstein, PT, DPT
• Brenna Bourke, LCSW
• Christina Boutsicaris, MD
• Julia Marie Bove, LMFT
• Bowdental
• Natasha Ann Bowen, M.D.
• Matthew M Bowersox, M.D.
• Joshua Bowes-Carlson, LSW
• Susan Haendle Bowker, MSW

• All providers in Evanston, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.