NPIMap

Organization Active NPI

Jeffrey W Bowman DMD PC

  • General Practice Dentistry
  • Victor, ID
National Provider Identifier
1922269331
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3162 Issued in ID
Legal business name
JEFFREY W BOWMAN DMD PC
Practice address
741 S 50 W
Suite a
Victor, ID 83455-5345
Phone
(208) 787-2323
NPI assigned
Jun 18, 2008
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Jeffrey Wildan Bowman, DMD
Title
Owner - Dentist
Phone
(208) 787-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D3162 ID Primary

Addresses

Primary practice location

741 S 50 W
Suite a
Victor, ID 83455-5345

Mailing address

741 S 50 W
Suite a
Victor, ID 83455-5345
Phone (208) 787-2323

Other names 1

  • Grand Teton Denteal Care Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1922269331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 S 50 W",
            "address_2": "SUITE A",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834555345",
            "telephone_number": "208-787-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S 50 W",
            "address_2": "SUITE A",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834555345",
            "telephone_number": "208-787-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W BOWMAN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "WILDAN",
        "authorized_official_title_or_position": "OWNER - DENTIST",
        "authorized_official_telephone_number": "208-787-2323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Teton Denteal Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Victor, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.