Robert Scott Owen, D.D.S.

Key facts

NPI

1285740340

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

18262 (OH)

Practice address

1919 Newark Granville Rd
Granville, OH 43023-9153

Phone

(740) 587-4488

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2007.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1285740340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 NEWARK GRANVILLE RD",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239153",
            "telephone_number": "740-587-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NEWARK GRANVILLE RD",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239153",
            "telephone_number": "740-587-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "18262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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