John Leonard Bacon, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

3596 Issued in AZ

Practice address

323 N Leroux St Ste 100
Flagstaff, AZ 86001-4542

Phone

(928) 774-1168

Fax

(928) 779-6349

NPI assigned

Feb 7, 2007

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1427198522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N LEROUX ST STE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014542",
            "telephone_number": "928-774-1168",
            "fax_number": "928-779-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N LEROUX ST STE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014542",
            "telephone_number": "928-774-1168",
            "fax_number": "928-779-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "JOHN",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "3596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3596",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@flagstaffdentist.com",
            "affiliation": "N",
            "address_1": "323 N LeRoux St Ste 100",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860014542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen C. Babcock, M.ED.
• Sheila Marie Babendir, EDD, LPC
• Rebecca Baca
• Cara Sprague Bachman, MD
• Back & Neck Center P.C.
• William John Badger, M.D.
• Brittany Kay Badour
• Douglas E. Baer Sr., RPH
• Paula D Baglioni, M.D.
• Sandy D Bailey, RN

• Dentist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.