Stacy L Bowen, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

WV 3620 Issued in WV

Practice address

319 Main St.
Clay, WV 25043

Phone

(304) 587-7495

Fax

(304) 587-7524

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bowen & Bowen, PLLC

  • General Practice Dentistry
  • Clay, WV
  • NPI 1497867964
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306998125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CANTERBURY CIR",
            "city": "ELKVIEW",
            "state": "WV",
            "postal_code": "250719467",
            "telephone_number": "304-965-0520",
            "fax_number": "304-587-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 MAIN ST.",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "25043",
            "telephone_number": "304-587-7495",
            "fax_number": "304-587-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "STACY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "WV 3620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Rene Boggs
• Daisy Marie Bollinger
• Tracie F Bonner, FNP
• Bowen & Bowen, PLLC
• Gary M Bowen II, D.D.S.
• Jennifer Bragg
• Patricia L Bragg
• Kelli Nadine Brandenburg
• Dana Louise Brannon
• Angela B. Brown, FNP-C

• All providers in Clay, WV
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.