Active NPI
David R Bowser III, DMD
- General Practice Dentistry
- Fishertown, PA
National Provider Identifier
1851475313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS035002
- Practice address
- 114 Ridgewood Drive
Fishertown, PA 15539 - Phone
- (814) 839-9908
- Fax
- (814) 839-9925
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS035002 | PA | Primary |
Addresses
Primary practice location
114 Ridgewood Drive
Fishertown, PA 15539
Mailing address
PO Box 209
114 Ridgewood Drive
Fishertown, PA 15539
Phone (814) 839-9908
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1702634 | Other | UNITED CONCORDIA PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160408000705 | PA | Order and Referring Only - Dentist | 9638477508 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035002 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851475313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 209",
"address_2": "114 RIDGEWOOD DRIVE",
"city": "FISHERTOWN",
"state": "PA",
"postal_code": "15539",
"telephone_number": "814-839-9908",
"fax_number": "814-839-9925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 RIDGEWOOD DRIVE",
"city": "FISHERTOWN",
"state": "PA",
"postal_code": "15539",
"telephone_number": "814-839-9908",
"fax_number": "814-839-9925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWSER",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS035002",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PROVIDER",
"identifier": "1702634",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fishertown, PA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.