D'Wayne Fowler, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9159 Issued in GA

Practice address

326 N Main St
Ellijay, GA 30540-3397

Phone

(706) 635-7453

Fax

(706) 276-2833

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699789537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N MAIN ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403397",
            "telephone_number": "706-635-7453",
            "fax_number": "706-276-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 N MAIN ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403397",
            "telephone_number": "706-635-7453",
            "fax_number": "706-276-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "D'WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Dwayne Ellington, EMT
• Stacey Lynne Evans-Paulin, PA-C
• Family Life Chiropractic Center III
• Robert Stephen Feldman, MD
• Marissa Lee Fidler, PA-C
• Hilary Fowler
• Gateway Treatment Centers, LLC
• Generative Therapy Center LLC (Generative Therapy Center)
• Miriam F Gentry, M.D.
• Georgia Mountains Health Services, Inc.

• General Practice Dentistry in Ellijay, GA
• Providers in Ellijay, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.