Bowie Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BOWIE DENTAL GROUP LLC

Doing business as

Gallant Fox Dental

Practice address

14300 Gallant Fox LN Ste 208
Bowie, MD 20715-4033

Phone

(301) 464-3500

NPI assigned

Jan 23, 2019

Last updated

Jan 23, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stanley Park, DDS

Title

Owner/Member

Phone

(301) 464-3500

Specialties & licenses 1

Addresses

Other names 1

• Gallant Fox Dental Doing business as

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1093279176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN STE 208",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154033",
            "telephone_number": "301-464-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN STE 208",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154033",
            "telephone_number": "301-464-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWIE DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "301-464-3500",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gallant Fox Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denaysha Donnell Bowen
• Bowie Center Limited Partnership (Larkin Chase Center)
• Bowie Center Limited Partnership (Larkin Chase Center)
• Bowie Comcare Pharmacy LLC (Comcare Pharmacy)
• Bowie Dental Associates LLC
• Bowie Foot and Ankle
• Bowie Hearing Center
• Bowie Internal Medicine Associates
• Bowie Internal Medicine Associates
• Bowie Med Optometry, LLC (Myeyedr)

• General Practice Dentistry in Bowie, MD
• Providers in Bowie, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.