Provider Demographics
NPI:1568536217
Name:BEKKER, JAMES H (DMD PC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:BEKKER
Suffix:
Gender:M
Credentials:DMD PC
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:H
Other - Last Name:BEKKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1434 EAST 9400 SOUTH
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-2916
Mailing Address - Country:US
Mailing Address - Phone:801-571-5800
Mailing Address - Fax:801-571-5522
Practice Address - Street 1:1434 EAST 9400 SOUTH
Practice Address - Street 2:SUITE 205
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-2916
Practice Address - Country:US
Practice Address - Phone:801-571-5800
Practice Address - Fax:801-571-5522
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT142542122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT52876319003Medicaid