BOWIE DENTAL GROUP LLC (NPI# 1093279176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093279176 |
| Entity Type | Organization |
| Organization Name | BOWIE DENTAL GROUP LLC |
| Practice Address |
14300 Gallant Fox Ln Ste 208 Bowie MD 20715-4033 |
| Practice Telephone | 3014643500 |
| Mailing Telephone | 3014643500 |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |
| Authorized Official Name | STANLEY PARK (OWNER/MEMBER) |
| Authorized Official Telephone | 3014643500 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Gallant Fox Dental | Doing Business As Name - Organization |
| Street Address |
14300 GALLANT FOX LN STE 208 |
| City | BOWIE |
| State | MD |
| Zip Code | 20715-4033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304757 | Aynia V Dorsey | Occupational Therapist | 6915 Laurel Bowie Rd Ste 205b, Bowie, MD 20715 | 2018-08-04 |
| 1558852988 | Dmv Foot and Ankle Center | Podiatrist | 15480 Annapolis Rd Ste 202-437, Bowie, MD 20715 | 2018-05-22 |
| 1861918435 | Ryan Leigh Brown | Psychologist | 3231 Superior Lane, Suite, A6, Bowie, MD 20715 | 2017-08-16 |
| 1073060430 | Chinwendu Ezeoru | Nurse Practitioner | 13004 Viewpoint Ln, Bowie, MD 20715 | 2016-09-02 |
| 1386094977 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 15501 Annapolis Rd, Suite 400, Bowie, MD 20715 | 2016-06-15 |
| 1083003164 | Megan Elizabeth Cooper | Social Worker | 2812 Bosworth Ln, Bowie, MD 20715 | 2015-01-13 |
| 1467856740 | Nathan-todd Consulting | Community/Behavioral Health | 3231 Superior Court Lane,# A5, Bowie, MD 20715 | 2014-10-15 |
| 1841534468 | Varsity Professional Rehabilitation and Staffing, LLC | Physical Therapist | 14000 Jericho Park Road, Bowie, MD 20715 | 2012-11-20 |
| 1013269893 | Felix Chukwudi Ohams | Registered Nurse | 7613 Old Chapel Dr, Bowie, MD 20715 | 2012-10-04 |
| 1720336464 | Tara Marie Hatfield | Physical Therapist | 100 Whitemarsh Park Drive, Bowie, MD 20715 | 2012-08-28 |
| Find all providers in zip 20715 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932667367 | Dhruva Atul Gurjar | Dentist | 4321 Collington Rd Ste 210, Bowie, MD 20716-2263 | 2019-03-05 |
| 1760924559 | Emona Kraja | Dentist | 3060 Mitchellville Rd Ste 105, Bowie, MD 20716-3965 | 2016-11-09 |
| 1295098325 | Margo Ree Adesanya | Dentist | 6911 Laurel - Bowie Rd, Suite 204, Bowie, MD 20715 | 2012-06-22 |
| 1285901801 | Neibauer Dental Care, P.C. | Dentist | 6141 Highbridge Rd, Bowie, MD 20715 | 2011-11-28 |
| 1063655009 | Daquant N Hornbeak | Dentist | 4000 Mitchellville Rd Ste B426, Bowie, MD 20716-3159 | 2009-04-07 |
| 1235320847 | Alvin Elliot Lee | Dentist | 6808 Laurel Bowie Rd, Bowie, MD 20715-1709 | 2007-08-08 |
| 1508078007 | Ambiance Dental Spa | Dentist | 12500 A Fairwood Parkway, Bowie, MD 20720 | 2007-05-04 |
| 1336362961 | Robert L St John | Dentist | 307 W Tarrant St, Suite C, Bowie, TX 76230 | 2007-04-11 |
| 1730218603 | Glenn Cocoros | Dentist | 1522 Pointer Ridge Pl, Suite K, Bowie, MD 20716-1875 | 2007-03-05 |
| 1184772642 | Abiodun Adesanya | Dentist | 6911 Laurel Bowie Rd, Suite 204, Bowie, MD 20715-1712 | 2007-01-08 |
| Find all providers in BOWIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.