Individual provider Active NPI

K. Douglas Bowers, DDS

  • General Practice Dentistry
  • Mary Esther, FL
National Provider Identifier
1730515602
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN9990 Issued in FL
Practice address
151 Mary Esther Blvd
Suite 402
Mary Esther, FL 32569-1972
Phone
(850) 796-2838
Fax
(850) 796-3204
NPI assigned
Sep 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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 DN9990 FL Primary

Addresses

Primary practice location

151 Mary Esther Blvd
Suite 402
Mary Esther, FL 32569-1972

Mailing address

151 Mary Esther Blvd
Suite 402
Mary Esther, FL 32569-1972
Phone (850) 796-2838

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

State licenses

LicenseStateTypeSpecialty
DN9990FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1730515602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MARY ESTHER BLVD",
            "address_2": "SUITE 402",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691972",
            "telephone_number": "850-796-2838",
            "fax_number": "850-796-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARY ESTHER BLVD",
            "address_2": "SUITE 402",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691972",
            "telephone_number": "850-796-2838",
            "fax_number": "850-796-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "K.",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mary Esther, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.