Individual provider Active NPI

Edward Allen Bowns, DMD

  • General Practice Dentistry
  • Suwanee, GA
National Provider Identifier
1700929403
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11075 Issued in GA
Practice address
3630 Peachtree Pkwy
Suite 311
Suwanee, GA 30024-6049
Phone
(770) 495-9575
Fax
(770) 495-8081
NPI assigned
Feb 14, 2007
Sex
Male
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
General Practice Dentistry 1223G0001X 11075 GA Primary

Addresses

Primary practice location

3630 Peachtree Pkwy
Suite 311
Suwanee, GA 30024-6049

Mailing address

3630 Peachtree Pkwy
Suite 311
Suwanee, GA 30024-6049
Phone (770) 495-9575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160110000011 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517269418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11075GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Creek Dental Care, P.C. General Practice 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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700929403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 PEACHTREE PKWY",
            "address_2": "SUITE 311",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246049",
            "telephone_number": "770-495-9575",
            "fax_number": "770-495-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 PEACHTREE PKWY",
            "address_2": "SUITE 311",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246049",
            "telephone_number": "770-495-9575",
            "fax_number": "770-495-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWNS",
        "first_name": "EDWARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.