Active NPI
Donald J. Bekedam, D.D.S.
- General Practice Dentistry
- Atwater, CA
National Provider Identifier
1912010083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23474
- Practice address
- 2665 Alabama St
Atwater, CA 95301-2908 - Phone
- (209) 358-1577
- NPI assigned
- Aug 16, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23474 | CA | Primary |
Addresses
Primary practice location
2665 Alabama St
Atwater, CA 95301-2908
Mailing address
2665 Alabama St
Atwater, CA 95301-2908
Phone (209) 358-1577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23474 | CA | MD | Certified Respiratory Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donald J. Bekedam, D.D.S., Inc. | General Practice | Past | Accepting new patients |
| Myriam M Defay DDS Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Atwater, CA
- NPI 1790935856
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222300800000",
"number": "1912010083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2665 ALABAMA ST",
"city": "ATWATER",
"state": "CA",
"postal_code": "953012908",
"telephone_number": "209-358-1577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2665 ALABAMA ST",
"city": "ATWATER",
"state": "CA",
"postal_code": "953012908",
"telephone_number": "209-358-1577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEKEDAM",
"first_name": "DONALD",
"middle_name": "J.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2008-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "23474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atwater, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.