Joseph Dylan Bowles, DDS

Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Cleburne, TX

NPI 1922085331 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1922085331
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
21480 (TX)
Practice address
110 Del Rio CT
Cleburne, TX 76033-5125
Phone
(409) 489-6622
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Opted out of Medicare
Yes, effective May 6, 2016 through May 6, 2028

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
21480TXMDOral and Maxillofacial Surgery (Dentist)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21480 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21480 TX Yes

Addresses

Primary practice location

110 Del Rio CT
Cleburne, TX 76033-5125

Mailing address

1237 CR 197
Jonesboro, TX 76538
Phone (910) 922-9644

Other providers in Cleburne, TX

All providers in Cleburne, TX · Oral and Maxillofacial Surgery (Dentist) in Texas

Sources for this page

Verify at the official NPI Registry.