Individual provider Active NPI

Michael Patrick Owen, D.M.D.

  • Student in an Organized Health Care Education/Training Program
  • Iowa City, IA
National Provider Identifier
1033472048
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RES-30683 Issued in IA
Practice address
801 Newton Rd
Iowa City, IA 52242-1001
Phone
(319) 335-7440
Fax
(319) 335-7451
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9195 KY
Student in an Organized Health Care Education/Training Program 390200000X RES-30683 IA Primary

Addresses

Primary practice location

801 Newton Rd
Iowa City, IA 52242-1001

Mailing address

322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone (319) 335-7440

Other practice location 1

2215 Portland Ave
Louisville, KY 40212-1033
Phone (502) 772-8160

Other practice location 2

2005 Knight Lane Bldg H
Navy Medicine Support Command
Jacksonville, FL 32212-0140
Phone (904) 542-7200

Other practice location 3

2005 Knight Lane Bldg H
Navy Medicine Support Command
Jacksonville, FL 32212-0140
Phone (904) 542-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9195KYMDDentist
RES-30683IAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
United States Navy Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1033472048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DENTAL SCIENCE BLDG S",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NEWTON RD",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402121033",
            "country_code": "US",
            "telephone_number": "502-772-8160",
            "fax_number": "502-772-8108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 Knight Lane Bldg H",
            "address_2": "Navy Medicine Support Command",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322120140",
            "country_code": "US",
            "telephone_number": "904-542-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 Knight Lane Bldg H",
            "address_2": "Navy Medicine Support Command",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322120140",
            "country_code": "US",
            "telephone_number": "904-542-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9195",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "RES-30683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.