NPIMap

Organization Active NPI

Pam Bouton DDS

Doing business as Hiawatha Dental Center

  • Dentist
  • Owego, NY
National Provider Identifier
1205969052
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
044603 Issued in NY
Legal business name
PAM BOUTON DDS
Doing business as
Hiawatha Dental Center
Practice address
153 Main Street
Owego, NY 13827
Phone
(607) 687-7536
NPI assigned
Mar 13, 2007
Last updated
Jun 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Pam Bouton, DDSNPI 1275956450
Title
Owner
Phone
(607) 687-7536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 044603 NY Primary

Addresses

Primary practice location

153 Main Street
Owego, NY 13827

Mailing address

153 Main Street
Owego, NY 13827
Phone (607) 687-7536

Other names 1

  • Hiawatha Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

153 Main St
Owego, NY 13827
Phone (607) 687-0891

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1205969052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 MAIN STREET",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 MAIN STREET",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAM BOUTON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "BOUTON",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-687-7536",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hiawatha Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.