Johnny L Bakker, DDS
Dentist, General Practice in Springdale, AR. Individual provider (NPI-1).
NPI number1366484511
StatusActive
Last updated in NPPESJan 8, 2015
Details
- NPI
- 1366484511
- Entity type
- Individual (NPI-1)
- Name
- Mr. Johnny L Bakker
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2006
- Last updated
- Jan 8, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | AR2398 | AR | Yes |
Practice location
418 W Maple AveSpringdale, AR 72764-5334
Phone 479-751-8820 · Fax 479-751-3117
Mailing address
418 W Maple AveSpringdale, AR 72764-5334
Phone 479-751-8820 · Fax 479-751-3117
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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