Tracy Austin Bowden, D.D.S.
Individual provider Active NPI Dentist · Timonium, MD
NPI 1508947284 · NPPES record last updated Oct 12, 2016
Key facts
- NPI
- 1508947284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 10463 (MD)
- Practice address
- 2326 York Rd
Suite 200
Timonium, MD 21093-2266 - Phone
- (410) 828-5699
- Fax
- (410) 828-0711
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 10463 | MD | MD | Dentist |
Interoperability endpoints
- tbowden1404@direct.umm.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10463 | MD | Yes |
Addresses
Primary practice location
2326 York Rd
Suite 200
Timonium, MD 21093-2266
Mailing address
2326 York Rd
Suite 200
Timonium, MD 21093-2266
Phone (410) 828-5699
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 545404200 | Medicaid | MD |
Other providers in Timonium, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2016. 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.