Individual provider Active NPI

Michael S Nowell, DDS PC

  • General Practice Dentistry
  • Dothan, AL
National Provider Identifier
1861492639
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3613 Issued in AL
Practice address
1609 W Main St
Suite 204
Dothan, AL 36301-1362
Phone
(334) 793-9826
Fax
(334) 671-2956
NPI assigned
Jul 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 3613 AL Primary

Addresses

Primary practice location

1609 W Main St
Suite 204
Dothan, AL 36301-1362

Mailing address

1609 W Main St
Suite 204
Dothan, AL 36301-1362
Phone (334) 793-9826

Other identifiers 2

IdentifierTypeStateIssuer
666371OtherPAUNITED CONCORDIA
23707OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20160104000045 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951603323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3613ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861492639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 W MAIN ST",
            "address_2": "SUITE 204",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011362",
            "telephone_number": "334-793-9826",
            "fax_number": "334-671-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 W MAIN ST",
            "address_2": "SUITE 204",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011362",
            "telephone_number": "334-793-9826",
            "fax_number": "334-671-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWELL",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "666371",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "23707",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.