Charles Raymond Bowen, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0160000507 Issued in VT

Practice address

58 Court St
Middlebury, VT 05753-4450

Phone

(802) 388-6344

Fax

(802) 388-4103

NPI assigned

Jul 31, 2006

Last updated

Sep 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2014 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maple View Oral and Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Middlebury, VT
  • NPI 1699001024
  NPD (past)
• University of Vermont Medical Center Inc

  dba Uvm Medical Center

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1750397980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 COURT ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057534450",
            "telephone_number": "802-388-6344",
            "fax_number": "802-388-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 COURT ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057534450",
            "telephone_number": "802-388-6344",
            "fax_number": "802-388-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VT",
            "license": "0160000507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1565",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02500030",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1565",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "102V102",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula M Birdsall, RD
• Caitlin Bone, D.C.
• Sally Eleanor Borden
• Jacqueline M Botala
• Justin P Bouchard, PRSS
• Scott Martin Bowen, DMD MD MPH
• Philip B. Bowman, MA
• Mary Ann Dattilo Boyd, LICSW
• Johana Kashiwa Brakeley, M.D.
• Willis Breen, RPH

• Oral and Maxillofacial Surgery (Dentist) in Middlebury, VT
• Providers in Middlebury, VT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.