Provider Demographics
NPI:1457307902
Name:DYKMAN, DICK JAAP (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DICK
Middle Name:JAAP
Last Name:DYKMAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 W RAY RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3558
Mailing Address - Country:US
Mailing Address - Phone:480-782-1200
Mailing Address - Fax:480-782-6682
Practice Address - Street 1:2480 W RAY RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3558
Practice Address - Country:US
Practice Address - Phone:480-782-1200
Practice Address - Fax:480-782-6682
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics