DR. BRENDA LYLE FOWLER (NPI# 1699966770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699966770 |
| Entity Type | Individual |
| Full Name | DR. BRENDA LYLE FOWLER |
| Credential | D.D.S. |
| Practice Address |
2408 S Lamar Blvd Suite 3 Oxford MS 38655-5345 |
| Practice Telephone | 6625134619 |
| Practice Fax Number | 6625135528 |
| Mailing Telephone | 6625134619 |
| Mailing Fax Number | 6625135528 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2017-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
3912-17 | MS | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871904342 | Brenda Fowler | Counselor | 1942 Nw Kearney St Ste 32, Portland, OR 97209-1426 | 2014-05-18 |
| 1174637896 | Brenda Fowler | Nurse Practitioner | 604 S Pecan St, Dermott, AR 71638-2228 | 2006-08-19 |
| 1750907986 | Brenda Fowler | Chore Provider | 1325 Airmotive Way, Reno, NV 89502-3201 | 2020-06-23 |
| 1194280537 | Brenda Fowler | Registered Nurse | 100 South Bliss Avenue, Tahlequah, OK 74464 | 2019-02-08 |
| 1760927800 | Brenda Fowler | Registered Nurse | 966 W. 21st Street, Chicago, IL 60608 | 2016-12-28 |
| 1508095993 | Brenda Marie Fowler | Counselor | 4020 Folker St, Anchorage, AK 99508-5321 | 2009-07-07 |
| 1437195294 | Brenda Jean Fowler | Pharmacist | 514 W Main St, Sac City, IA 50583-1727 | 2006-06-21 |
| Street Address |
2408 S LAMAR BLVD SUITE 3 |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-5345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356604664 | Go Orthodontics Partnership | Dentist | 2408 S Lamar Blvd, Suite 2, Oxford, MS 38655-5345 | 2012-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184958639 | Rania Livada | Dentist | 12161 County Road 103, Suite 101, Oxford, FL 34484-2985 | 2009-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497112825 | Mississippi Periodontics and Implants Pllc | Dentist | 218 West Jackson Street, Ridgeland, MS 39157 | 2016-01-15 |
| 1932531373 | North Mississippi Periodontics & Implant Dentistry Pllc | Dentist | 103 Park Gate Ext, Tupelo, MS 38801-3038 | 2013-08-08 |
| 1851640437 | Ms Periodontic Specialists Group, Pllc | Dentist | 209 Woodline Dr., Flowood, MS 39232 | 2012-08-29 |
| 1790069854 | Periodontal Associates of Jackson, P.a. | Dentist | 406 Briarwood Dr., Ste. 101, Jackson, MS 39206 | 2011-10-06 |
| 1992997159 | Rodney C Richardson | Dentist | 1609 24th Ave, Meridian, MS 39301-3112 | 2007-08-13 |
| 1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
| 1417166703 | R. Clarke Stewart | Dentist | 406 Briarwood Dr Ste 101, Jackson, MS 39206-3059 | 2007-05-22 |
| 1750594412 | James Michael Robertson | Dentist | 103 Parkgate Drive Extended, Tupelo, MS 38801-3038 | 2007-05-08 |
| 1134341407 | Nichols Periodontics LLC | Dentist | 2401 5th Street North, Suite 2, Columbus, MS 39705 | 2007-05-03 |
| 1689719486 | Charles Joseph Caskey | Dentist | 218 West Jackson St., Ridgeland, MS 39157 | 2007-02-20 |
| Find all providers with the same taxonomy | ||||
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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.