Nicholas Ryan Bakkum, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2018 Issued in ND

Practice address

204 2ND Ave NE
Hazen, ND 58545-4420

Phone

(701) 748-2730

NPI assigned

Jun 3, 2008

Last updated

Jun 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Dental Group LLC

  • General Practice Dentistry
  • Fargo, ND
  • NPI 1639336316
  NPD (past)
• Mark E. Jahraus, DDS, PC

  dba Jahraus Dental Clinic

  • General Practice Dentistry
  • Hazen, ND
  • NPI 1972723609
  NPD (past)
• Priscila J Jelsing DDS PC

  • Dentist
  • Hazen, ND
  • NPI 1952692451
  NPD (past)

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1669631859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 2ND AVE NE",
            "city": "HAZEN",
            "state": "ND",
            "postal_code": "585454420",
            "telephone_number": "701-748-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 2ND AVE NE",
            "city": "HAZEN",
            "state": "ND",
            "postal_code": "585454420",
            "telephone_number": "701-748-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKKUM",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 701 Therapy PLLC
• Kayleen R Alexander, MS, LAT, ATC
• Anna Mae Batke, NP
• Madison June Bennett, PT
• Rhonda Biffert
• Kimberley Dawn Binstock, FNP
• Michael Blacksmith, DO

• General Practice Dentistry in Hazen, ND
• Providers in Hazen, ND by specialty
• General Practice Dentistry in North Dakota

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