Individual provider Active NPI

Melissa Bowler, DDS

  • Dentist
  • Collinsville, OK
National Provider Identifier
1629080866
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5715 Issued in OK
Practice address
1310 W Main St
Collinsville, OK 74021-3012
Phone
(918) 371-3774
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5715 OK Primary

Addresses

Primary practice location

1310 W Main St
Collinsville, OK 74021-3012

Mailing address

1310 W Main St
Collinsville, OK 74021-3012
Phone (918) 371-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20160111001508 OK Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2365744117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5715OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa S Bowler DDS PC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629080866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W MAIN ST",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740213012",
            "telephone_number": "918-371-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W MAIN ST",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740213012",
            "telephone_number": "918-371-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLER",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, OK

Sources for this page

Verify at the official NPI Registry.