Individual provider Active NPI

Robert Lee Bowling, DMD

  • General Practice Dentistry
  • Gridley, CA
National Provider Identifier
1356774251
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60964 Issued in CA
Practice address
1080 Sycamore St
Gridley, CA 95948-3041
Phone
(530) 846-3666
Fax
(530) 846-5771
NPI assigned
Aug 14, 2013
Last updated
Aug 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60964 CA Primary

Addresses

Primary practice location

1080 Sycamore St
Gridley, CA 95948-3041

Mailing address

1080 Sycamore St
Gridley, CA 95948-3041
Phone (530) 846-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150318000333 CA Order and Referring Only - Other (Non-Physician) 7416274147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60964CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1356774251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 SYCAMORE ST",
            "city": "GRIDLEY",
            "state": "CA",
            "postal_code": "959483041",
            "telephone_number": "530-846-3666",
            "fax_number": "530-846-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 SYCAMORE ST",
            "city": "GRIDLEY",
            "state": "CA",
            "postal_code": "959483041",
            "telephone_number": "530-846-3666",
            "fax_number": "530-846-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLING",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gridley, CA

Sources for this page

Verify at the official NPI Registry.