Individual provider Active NPI

Mark V Cowley, DDS

  • General Practice Dentistry
  • South Ogden, UT
National Provider Identifier
1821117474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
141691-9922 Issued in UT
Practice address
5685 S 1475 E
Suite 1a
South Ogden, UT 84403-4716
Phone
(801) 475-8000
Fax
(801) 475-8019
NPI assigned
Mar 28, 2007
Sex
Male
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
General Practice Dentistry 1223G0001X 141691-9922 UT Primary

Addresses

Primary practice location

5685 S 1475 E
Suite 1a
South Ogden, UT 84403-4716

Mailing address

5685 S 1475 E
Suite 1a
South Ogden, UT 84403-4716
Phone (801) 475-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20160106000560 UT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0941502090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821117474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 S 1475 E",
            "address_2": "SUITE 1A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034716",
            "telephone_number": "801-475-8000",
            "fax_number": "801-475-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 S 1475 E",
            "address_2": "SUITE 1A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034716",
            "telephone_number": "801-475-8000",
            "fax_number": "801-475-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWLEY",
        "first_name": "MARK",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "141691-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

Verify at the official NPI Registry.