Ajdahan Deniz Bicak, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E1939 Issued in AR

Practice address

301 SW 16TH St
Bentonville, AR 72712-7173

Phone

(479) 273-2228

Fax

(479) 273-3338

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• A. D. Bicak Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sovereign Force, PA

  dba The Clinic at Commerce Centre

  • Primary Care Clinic/Center
  • Bentonville, AR
  • NPI 1629252440
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1316904865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SW 16TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127173",
            "telephone_number": "479-273-2228",
            "fax_number": "479-273-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SW 16TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127173",
            "telephone_number": "479-273-2228",
            "fax_number": "479-273-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICAK",
        "first_name": "AJDAHAN",
        "middle_name": "DENIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A.",
            "last_name": "BICAK",
            "middle_name": "D.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Shalini Bichala, MBBS
• Lindsay A Bilby
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• Amber Billiard
• James A Bilyeu, M.D.

• Family Medicine Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.