Lynn R Bowen, DDS
Individual provider Active NPI General Practice Dentistry · Lagrange, IN
NPI 1528022092 · NPPES record last updated Nov 24, 2010
Key facts
- NPI
- 1528022092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 8550 (IN)
- Practice address
- 210 W South St
Lagrange, IN 46761-2233 - Phone
- (260) 463-7006
- Fax
- (260) 463-4135
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8550 | IN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8550 | IN | Yes |
Addresses
Primary practice location
210 W South St
Lagrange, IN 46761-2233
Mailing address
210 W South St
Lagrange, IN 46761-2233
Phone (260) 463-7006
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200956730A | Medicaid | IN |
Other providers in Lagrange, IN
- Courtney Boggs
- Sarah Bolinger
- Bontrager Family Dentistry LLC
- Kalyssa Mae Bontrager
- Booth Medical Center PC
- Robin D Brauchla
- Rebecca Nicole Brueck
- Elizabeth R. Burkhart
- Louis Bustos
- Megan Marie Buuck
All providers in Lagrange, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2010. 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.