Active NPI
R Mark Owens DMD PA
- Dentist
- Pearl, MS
National Provider Identifier
1255415220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 301197
- Legal business name
- R MARK OWENS DMD PA
- Practice address
- 642 S Pearson Road
Pearl, MS 39208 - Phone
- (601) 939-2377
- Fax
- (601) 939-2529
- NPI assigned
- Oct 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Mark Owens, DMD
- Title
- Owner
- Phone
- (601) 939-2377
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 301197 | MS | Primary |
Addresses
Primary practice location
642 S Pearson Road
Pearl, MS 39208
Mailing address
642 S Pearson Road
Pearl, MS 39208
Phone (601) 939-2377
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03650331 | Medicaid | MS | |
| 425491211 | Other | MS | BCBS OF MS |
| 902980 | Other | MS | UNITED CONCORDIA |
National Provider Directory
National Provider DirectoryLocations
642 S Pearson Rd
Pearl, MS 39208
Phone (601) 939-2377
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Pearl, MS
- NPI 1184998981
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1306454400000",
"number": "1255415220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "642 S PEARSON ROAD",
"city": "PEARL",
"state": "MS",
"postal_code": "39208",
"telephone_number": "601-939-2377",
"fax_number": "601-939-2529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "642 S PEARSON ROAD",
"city": "PEARL",
"state": "MS",
"postal_code": "39208",
"telephone_number": "601-939-2377",
"fax_number": "601-939-2529"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "R MARK OWENS DMD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-25",
"last_updated": "2011-05-27",
"status": "A",
"authorized_official_last_name": "OWENS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "MARK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "601-939-2377",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MS",
"license": "301197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03650331",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MS",
"identifier": "425491211",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "902980",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pearl, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.