Robert Jaaron Fowers

Individual provider Active NPI General Practice Dentistry · Richland, MO

NPI 1942990163 · NPPES record last updated Jun 26, 2025

Key facts

NPI
1942990163
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2025024490 (MO)
Practice address
304 W Washington Ave
Richland, MO 65556-7101
Phone
(877) 406-2662
NPI assigned
May 10, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250711000352 MO Practitioner - Dentist 4880109701 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Medical Center, Inc. Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2025024490 MO Yes

Addresses

Primary practice location

304 W Washington Ave
Richland, MO 65556-7101

Mailing address

114 Paradise St
Waynesville, MO 65583-2925
Phone (557) 999-1066

Other providers in Richland, MO

All providers in Richland, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.