Provider Demographics
NPI:1083793541
Name:DOWNS, MICHAEL OWEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:OWEN
Last Name:DOWNS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11014 BLIX ST.
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1203
Mailing Address - Country:US
Mailing Address - Phone:949-500-9488
Mailing Address - Fax:
Practice Address - Street 1:500 N CENTRAL AVE
Practice Address - Street 2:SUITE 760
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3905
Practice Address - Country:US
Practice Address - Phone:818-242-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA399541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice