Individual provider Active NPI

Akintunde Anan Bowden, D.D.S.

  • General Practice Dentistry
  • Milwaukee, WI
National Provider Identifier
1962804534
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1001000-15 Issued in WI
Practice address
2555 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-2709
Phone
(414) 372-8080
Fax
(414) 562-8432
NPI assigned
Sep 25, 2014
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001000-15 WI Primary

Addresses

Primary practice location

2555 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-2709

Mailing address

2555 N. Martin Luther King Jr. Drive
Milwaukee Health Services, Inc.
Milwaukee, WI 53212-2709
Phone (414) 267-2670

Other practice location 1

8200 W Silver Spring Dr
Milwaukee, WI 53218-2552
Phone (414) 760-3900

Other identifiers 1

IdentifierTypeStateIssuer
100040538MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20141111000831 WI Practitioner - Oral Surgery 4082836853 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001000-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Health Services Inc CurrentSince Oct 6, 2014 Accepting new patients
Milwaukee Health Services, Inc. Current Accepting new patients
Milwaukee Health Services Inc CurrentSince Oct 6, 2014 Accepting new patients

Locations

2555 N Mlk Dr
Milwaukee, WI 53212
Phone (414) 267-2022

8200 W Silver Spring Dr
Milwaukee, WI 53218
Phone (414) 760-3900

Interoperability endpoints

  • Direct secure messaging: abowden526466@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1962804534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 N. MARTIN LUTHER KING JR. DRIVE",
            "address_2": "MILWAUKEE HEALTH SERVICES, INC.",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-267-2670",
            "fax_number": "414-562-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 N DR MARTIN LUTHER KING JR DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080",
            "fax_number": "414-562-8432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 W Silver Spring Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532182552",
            "country_code": "US",
            "telephone_number": "414-760-3900",
            "fax_number": "414-464-7258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "AKINTUNDE",
        "middle_name": "ANAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-25",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001000-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100040538",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.