Jacob Daniel Beckstrand, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D011509 Issued in AZ

Practice address

1143 Riata Valley Rd
Kingman, AZ 86409-2978

Phone

(435) 668-1724

NPI assigned

Aug 29, 2022

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)

Not 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 and National Provider Directory roles.

• Arizona Dental Sleep Therapy

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lake Havasu City, AZ
  • NPI 1760773907

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1891415147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 RIATA VALLEY RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092978",
            "telephone_number": "435-668-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 RIATA VALLEY RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092978",
            "telephone_number": "435-668-1724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 McCulloch Blvd N Ste A1",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035722",
            "country_code": "US",
            "telephone_number": "928-855-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Blvd, 2021 Cam Real Unit 300",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "86442",
            "country_code": "US",
            "telephone_number": "928-758-4888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKSTRAND",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D011509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Ray Bartholomew, DO
• Anne Marie Bathauer, MASTERS OF EDUCATION
• Battle Born Anesthesia Associates LTD
• Cortney Dawn Bautista, MS, LAC
• Mary Lee Beck, NP
• Brent J Bedke, MD
• Scott A Bell, RPH
• Blair Glee Berg, P.T.
• Annika Jeanette Bergeson, MSN, FNP-C
• Jeffrey Parke Bergeson, O.D.

• All providers in Kingman, AZ
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.