Bowie Oral and Facial Surgery Center Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

16204 Issued in MD

Legal business name

BOWIE ORAL AND FACIAL SURGERY CENTER INC.

Doing business as

Bowie Oral Surgery

Practice address

4175 N Hanson CT Ste 200
Bowie, MD 20716

Phone

(301) 760-4660

NPI assigned

Jul 28, 2018

Last updated

Jul 30, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nkemakonam Egolum, DDSNPI 1992142806

Title

Owner

Phone

(202) 460-0635

Specialties & licenses 1

Addresses

Other names 1

• Bowie Oral Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nkemakonam Egolum, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Johns Creek, GA
  • NPI 1992142806
  NPD Authorized official

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

{
    "created_epoch": "1532736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1972081313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 N HANSON CT STE 200",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163180",
            "telephone_number": "301-383-9883",
            "fax_number": "301-349-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 N HANSON CT STE 200",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20716",
            "telephone_number": "301-760-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWIE ORAL AND FACIAL SURGERY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-28",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "EGOLUM",
        "authorized_official_first_name": "NKEMAKONAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-460-0635",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "16204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bowie Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Bowie, MD
• Providers in Bowie, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.