Provider Demographics
NPI:1164953188
Name:OWEN, JAMES ALSTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALSTON
Last Name:OWEN
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 1:2041 GEORGIA AVE NW # 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-2280
Mailing Address - Country:US
Mailing Address - Phone:731-780-2649
Mailing Address - Fax:
Practice Address - Street 1:2041 GEORGIA AVE NW # 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-2280
Practice Address - Country:US
Practice Address - Phone:731-780-2649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program