Active NPI
James Howard Dykstra, D.D.S
- Dentist
- Harrington Park, NJ
National Provider Identifier
1063519700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI01473400
- Practice address
- 1 Park St
Suite 1
Harrington Park, NJ 07640-1905 - Phone
- (201) 768-0106
- Fax
- (201) 768-0107
- NPI assigned
- Sep 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI01473400 | NJ | Primary |
Addresses
Primary practice location
1 Park St
Suite 1
Harrington Park, NJ 07640-1905
Mailing address
1 Duke CT
Park Ridge, NJ 07656-2209
Phone (201) 476-0472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160223000371 | NJ | Order and Referring Only - Oral Surgery | 0345545703 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI01473400 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063519700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 DUKE CT",
"city": "PARK RIDGE",
"state": "NJ",
"postal_code": "076562209",
"telephone_number": "201-476-0472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PARK ST",
"address_2": "SUITE 1",
"city": "HARRINGTON PARK",
"state": "NJ",
"postal_code": "076401905",
"telephone_number": "201-768-0106",
"fax_number": "201-768-0107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKSTRA",
"first_name": "JAMES",
"middle_name": "HOWARD",
"name_prefix": "Mr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI01473400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrington Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.