Jonathan Bowling, DDS
Individual provider Active NPI General Practice Dentistry · Charleston, SC
NPI 1376706002 · NPPES record last updated Aug 23, 2022
Key facts
- NPI
- 1376706002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9763 (SC)
- Practice address
- 1841 Savage Rd
Charleston, SC 29407-4726 - Phone
- (843) 556-1050
- Fax
- (225) 766-5117
- NPI assigned
- Jul 2, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9763 | SC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Azalea Dental LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9763 | SC | Yes |
Addresses
Primary practice location
1841 Savage Rd
Charleston, SC 29407-4726
Mailing address
1841 Savage Rd
Charleston, SC 29407-4726
Phone (843) 556-1050
Other providers in Charleston, SC
- Sara D Bowers
- Deborah Anne Bowlby
- Kendall Bowler
- Anne Tipton Bowles
- Ingrid Ventura Bowling
- Jonathan Lawson Bowling
- Abbie Bowman
- Charles M Bowman
- John Imrie Bowman IV
- James Bowsher
All providers in Charleston, SC · General Practice Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.