Jason Alan Fowler, D.D.S.

Dentist · Great Lakes, IL

Individual Active NPI

NPI number 1417205873

Practice location

2410 Sampson St
Bldg. 237
Great Lakes, IL 60088-2942
Phone
(847) 688-3331

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NPI record

NPI
1417205873
Entity type
Individual (Type 1)
Enumeration date
August 16, 2012
Last updated
August 16, 2012
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 61748 CA

Mailing address

419 Eucalyptus Dr
Redlands, CA 92373-7126
Phone
(909) 709-6932

About Dr. Fowler

Jason Alan Fowler, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 2410 Sampson St, Bldg. 237, Great Lakes, IL 60088-2942. The NPI number 1417205873 was assigned on August 16, 2012 and the record was last updated on August 16, 2012.

Dr. Fowler lists a license in the registry: #61748 (CA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jason Alan Fowler, D.D.S.?

The NPI number is 1417205873.

What is the phone number of Dr. Fowler?

The phone number listed for the practice location is (847) 688-3331.

Where is Dr. Fowler located?

2410 Sampson St, Bldg. 237, Great Lakes, IL 60088-2942.

What is the taxonomy code for Dr. Fowler?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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