Provider Demographics
NPI:1811284136
Name:BOWLING & MAIERS, DDS, LTD.
Entity type:Organization
Organization Name:BOWLING & MAIERS, DDS, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-424-6100
Mailing Address - Street 1:1412 BLIZZARD DR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101
Mailing Address - Country:US
Mailing Address - Phone:304-424-6100
Mailing Address - Fax:
Practice Address - Street 1:1412 BLIZZARD DR
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101
Practice Address - Country:US
Practice Address - Phone:304-424-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2238122300000X
WV3718122300000X
WV3862122300000X
WV3683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013053388OtherINDIVIDUAL NPI
1912134750OtherINDIVIDUAL NPI
WV2238OtherSTATE LICENSE
WV3810020734Medicaid
3862OtherSTATE LICENSE
WV0136224000Medicaid
1710023072OtherINDIVIDUAL NPI
WV3683OtherSTATE LICENSE
WV3718OtherSTATE LICENSE
WV3810020731Medicaid
WV3810020730Medicaid
1619013984OtherINDIVIDUAL NPI
WV3810020766Medicaid