NPIMap

Organization Active NPI

Owen Dental, LLC.

  • General Practice Dentistry
  • Smithton, IL
National Provider Identifier
1881280030
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OWEN DENTAL, LLC.
Practice address
504 N Main St
Smithton, IL 62285-1518
Phone
(618) 233-9012
Fax
(618) 233-2399
NPI assigned
Dec 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Dr. Jon Owen, DMDNPI 1619329471
Title
President/Dentist
Phone
(618) 406-0965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

504 N Main St
Smithton, IL 62285-1518

Mailing address

8808 Wheat Dr
Troy, IL 62294-2272
Phone (618) 406-0965

National Provider Directory

National Provider Directory

Locations

504 N Main St
Smithton, IL 62285
Phone (618) 233-9012

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1881280030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8808 WHEAT DR",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622942272",
            "telephone_number": "618-406-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N MAIN ST",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622851518",
            "telephone_number": "618-233-9012",
            "fax_number": "618-233-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWEN DENTAL, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "618-406-0965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.