Individual provider Active NPI

Kimberly L McGowen, D.M.D.

  • Endodontics
  • Birmingham, AL
National Provider Identifier
1720192867
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
4804 Issued in AL
Practice address
3530 Independence Dr
Suite 3534
Birmingham, AL 35209-5710
Phone
(205) 871-9494
Fax
(205) 871-8939
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

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
Endodontics 1223E0200X 4804 AL Primary

Addresses

Primary practice location

3530 Independence Dr
Suite 3534
Birmingham, AL 35209-5710

Mailing address

3530 Independence Dr
Suite 3534
Birmingham, AL 35209-5710
Phone (205) 871-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720192867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 INDEPENDENCE DR",
            "address_2": "SUITE 3534",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095710",
            "telephone_number": "205-871-9494",
            "fax_number": "205-871-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 INDEPENDENCE DR",
            "address_2": "SUITE 3534",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095710",
            "telephone_number": "205-871-9494",
            "fax_number": "205-871-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWEN",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AL",
            "license": "4804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • 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.