Sally Elizabeth Owens, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12390 Issued in MN

Practice address

2308 Wyatt Ave
Stevens Point, WI 54481-3635

Phone

(715) 341-5441

Fax

(715) 341-4752

NPI assigned

Jun 12, 2007

Last updated

Apr 17, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sally Elizabeth Simmer Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Owens Family Dentistry LLC

  • General Practice Dentistry
  • Stevens Point, WI
  • NPI 1861804650
  NPD (past) Authorized official
• David J Owens, DDS

  • General Practice Dentistry
  • Stevens Point, WI
  • NPI 1790058865
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1316141518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 WYATT AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813635",
            "telephone_number": "715-341-5441",
            "fax_number": "715-341-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 WYATT AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813635",
            "telephone_number": "715-341-5441",
            "fax_number": "715-341-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "SALLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33608800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "190000964",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "SIMMER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Osl SP Operating LLC
• Paul R. Ostertag, D.D.S.
• Oswald Counseling Associates
• Lynne T Oswald, LCSW, LPC, CADC3
• Owens Family Dentistry LLC
• Ashley Ozanne, OD
• Tanner Ozanne
• Brian J. Pacyna, LAT
• Oscar G Padilla, MD
• Brehn N Pagel, PT

• General Practice Dentistry in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.