Individual provider Active NPI

Jila Bowman, DDS

  • Periodontics
  • Salem, OR
National Provider Identifier
1417169178
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D7919 Issued in OR
Practice address
2300 Lancaster Dr NE
Salem, OR 97305-1223
Phone
(503) 370-4313
Fax
(503) 375-5737
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X D7919 OR Primary

Addresses

Primary practice location

2300 Lancaster Dr NE
Salem, OR 97305-1223

Mailing address

2300 Lancaster Dr NE
Salem, OR 97305-1223
Phone (503) 370-4313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110815000392 OR Order and Referring Only - DentistPractitioner - Dentist 2062681737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1417169178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051223",
            "telephone_number": "503-370-4313",
            "fax_number": "503-375-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051223",
            "telephone_number": "503-370-4313",
            "fax_number": "503-375-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JILA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D7919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.