Individual provider Active NPI

Afton Norene Cowen, D.M.D.

  • General Practice Dentistry
  • Montgomery, AL
National Provider Identifier
1396016333
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5893 C1 Issued in AL
Practice address
1845 Cherry St
Montgomery, AL 36107-2613
Phone
(334) 420-5001
NPI assigned
Jan 23, 2012
Last updated
Dec 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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 5893 C1 AL Primary

Addresses

Primary practice location

1845 Cherry St
Montgomery, AL 36107-2613

Mailing address

PO Box 70365
Montgomery, AL 36107-0365
Phone (334) 420-5038

Other identifiers 1

IdentifierTypeStateIssuer
136442MedicaidAL

Other names 1

  • Dr. Afton Norene Ellis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20170608001521 AL Order and Referring Only - DentistPractitioner - Dentist 0345518726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5893 C1ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1396016333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70365",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361070365",
            "telephone_number": "334-420-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CHERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361072613",
            "telephone_number": "334-420-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWEN",
        "first_name": "AFTON",
        "middle_name": "NORENE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5893 C1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136442",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AFTON",
            "last_name": "ELLIS",
            "middle_name": "NORENE",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.