Douglas L. Fowler, DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5355 Issued in NC

Legal business name

DOUGLAS L. FOWLER, DDS, PLLC

Practice address

2520 N College Rd
Wilmington, NC 28405-8808

Phone

(910) 790-3836

Fax

(910) 790-5026

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Lane Fowler, DDS

Title

Owner

Phone

(910) 790-3836

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063557932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 N COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058808",
            "telephone_number": "910-790-3836",
            "fax_number": "910-790-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 N COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058808",
            "telephone_number": "910-790-3836",
            "fax_number": "910-790-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS L. FOWLER, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-790-3836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902HW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016MP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Elizabeth Dougherty, M.D.
• Regan B Dougherty
• Ryan Dougherty, PA-C
• Ryan Cameron Dougherty, M.D.
• Douglas F. Degroote, DDS
• Kylie Erin Douglas, BCBA
• Haeli Dove
• Kelli Avery Dove, CRNA
• Summer Dow
• Mary E Dowcett, P-LCSW

• General Practice Dentistry in Wilmington, NC
• Providers in Wilmington, NC by specialty
• General Practice Dentistry in North Carolina

• 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.