Daniel Anthony Bowen, D.D.S.
Individual provider Active NPI General Practice Dentistry · Grand Haven, MI
NPI 1720148893 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1720148893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 011964 (MI)
- Practice address
- 17000 Robbins Rd
Grand Haven, MI 49417-2788 - Phone
- (616) 846-7360
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 011964 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thornley and Associates DDS PC | Past | Accepting new patients | |
| Bethany Christian Services Inc. | Past | Accepting new patients |
Interoperability endpoints
- daniel.bowen.1@15079.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 011964 | MI | Yes |
Addresses
Primary practice location
17000 Robbins Rd
Grand Haven, MI 49417-2788
Mailing address
16200 Highland Dr
Spring Lake, MI 49456-2308
Phone (616) 846-8606
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4164048 | Medicaid | MI |
Other providers in Grand Haven, MI
- Shawn C Bonner
- Nicholas Michael Bontumasi
- Ashley Bookmyer
- Daniela Borecky
- Evelyn Bosman
- Susan Bowers
- Nicole Bowyer
- Sheryl Lynn Boynton
- Jaclyn Bradley
- Grace Ann Brady
All providers in Grand Haven, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.