MEDICARE: DR. KEVIN NOWINS D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DDS-10075	IA

General Provider Information

NPI Number	:	1861848400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN NOWINS D.M.D.

Provider Business Mailing Address
First Line	:	4150 EDGEWOOD RD NE STE 100
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-7106
Country	:	US
Telephone Number	:	319-366-8277
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 EDGEWOOD RD NE STE 100
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-7106
Country	:	US
Telephone Number	:	319-366-8277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2016
Last Update Date	:	08/10/2023

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