NPIMap

Organization Active NPI

Kim a Gowey DDS LTD

  • Dentist
  • Medford, WI
National Provider Identifier
1245355460
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5001790015 Issued in WI
Legal business name
KIM A GOWEY DDS LTD
Practice address
1034 W Broadway Ave
Medford, WI 54451-1310
Phone
(715) 748-4432
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kim A Gowey, DDSNPI 1528183464
Title
President
Phone
(715) 748-4432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5001790015 WI Primary

Addresses

Primary practice location

1034 W Broadway Ave
Medford, WI 54451-1310

Mailing address

PO Box 389
Medford, WI 54451-0389

Other names 1

  • Implant Dentistry of Wisconsin Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245355460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 389",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544510389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 W BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511310",
            "telephone_number": "715-748-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM A GOWEY DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOWEY",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-748-4432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5001790015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Implant Dentistry of Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, WI

Sources for this page

  • 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.