Jeffrey F Sowle, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

66D1616 Issued in ID

Practice address

601 East Main St
Kendrick, ID 83537-0160

Phone

(208) 289-3221

Fax

(208) 289-3721

NPI assigned

Jul 24, 2006

Last updated

Jul 8, 2007By 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 2

Medicare fee-for-service enrollment

Enrolled in ID

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

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.

• Jeffrey F. Sowle DDS PA

  • General Practice Dentistry
  • Kendrick, ID
  • NPI 1790959609
  NPD (past) Authorized official

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902828767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "KENDRICK",
            "state": "ID",
            "postal_code": "835370160",
            "telephone_number": "208-289-3221",
            "fax_number": "208-289-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EAST MAIN ST",
            "city": "KENDRICK",
            "state": "ID",
            "postal_code": "835370160",
            "telephone_number": "208-289-3221",
            "fax_number": "208-289-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOWLE",
        "first_name": "JEFFREY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "66D1616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5037569",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gritman Medical Center Inc (Kendrick Clinic)
• J K Ambulance
• Jeffrey F. Sowle DDS PA
• Kelly Marie Landle, P.A.-C
• Red Cross Pharmacy Inc

• General Practice Dentistry in Kendrick, ID
• Providers in Kendrick, ID by specialty
• General Practice Dentistry in Idaho

• 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.

Verify at the official NPI Registry.