Dustin Bowler, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

202787 Issued in CO

Practice address

4820 Lake Brook Dr Ste 100
Glen Allen, VA 23060-9291

Phone

(303) 882-7696

NPI assigned

Sep 10, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 8, 2019 through Jul 8, 2027

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.

• Riverside Ofs PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Purcellville, VA
  • NPI 1902699077
  NPD (past) Authorized official
• Potomac Surgical Arts,PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lansdowne, VA
  • NPI 1144987025
  NPD (past)
• Reston Oral and Facial Surgery PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Reston, VA
  • NPI 1639919194
  NPD (past)

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1033544937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 LAKE BROOK DR STE 100",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609291",
            "telephone_number": "303-882-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 LAKE BROOK DR STE 100",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609291",
            "telephone_number": "303-882-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLER",
        "first_name": "DUSTIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-10",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "202787",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bostwick Laboratories, Inc.
• Leslie Dana Bottoms, LPC
• Sabrina Bouldin
• Boundless Potential LLC
• William H Bowen, DPT
• Angela C. Bowman, LCSW
• Mary Elizabeth Bowman, ACNP-BC
• Emily Boxx, NP
• Richard Edward Boyd Jr., DMD
• Rachel Boykin, LPC

• Oral and Maxillofacial Surgery (Dentist) in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.