DR. BENNETT JON DYKSTRA (NPI# 1003979550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003979550 |
| Entity Type | Individual |
| Full Name | DR. BENNETT JON DYKSTRA |
| Credential | M.D. |
| Practice Address |
1333 Surgical Services Way Kalispell MT 59901-4844 |
| Practice Telephone | (406) 752-5000 |
| Practice Fax Number | 4067528220 |
| Mailing Telephone | 4067525000 |
| Mailing Fax Number | 4067528220 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 10388 | MT | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
10388 | MT | Allopathic & Osteopathic Physicians |
| Street Address |
1333 SURGICAL SERVICES WAY |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-4844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083616643 | Neal W Wilkinson | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2005-08-12 |
| 1639628761 | Mattie Murphy | Physician Assistant | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2016-09-30 |
| 1104295211 | Jaimee Gribben | Nurse Practitioner | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2015-09-18 |
| 1629458385 | Dimitra Maria Lotakis | Student in an Organized Health Care Education/Training Program | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2015-06-08 |
| 1053790063 | Kalispell Regional Medical Center Inc | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2015-05-22 |
| 1740413061 | Federico Gian Filippo Seifarth | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2009-09-03 |
| 1972748127 | Kalispell Regional Medical Center, Inc. | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2008-12-02 |
| 1194903377 | Joan C Driscoll | Nurse Practitioner | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2008-02-10 |
| 1669528287 | Erik Peltz | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2007-01-26 |
| 1962565432 | Stephen G Milheim | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275696742 | Northwest Montana Surgical Associates | Surgery | 1273 Burns Way, Kalispell, MT 59901-3109 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710119664 | Centers for Advanced Vein Care of Montana Pllc | Surgery | 1417 9th St S Ste 201, Great Falls, MT 59405-4509 | 2009-08-11 |
| 1881830610 | Benefis Medical Group | Surgery | 500 15th Avenue South, Great Falls, MT 59405-4304 | 2008-12-29 |
| 1780685636 | Michael B Orcutt | Surgery | 1400 29th St S Ste 201, Great Falls, MT 59405-5316 | 2005-08-02 |
| 1972918639 | Thomas Joseph Desmarais | Surgery | 1233 N 30th St, Billings, MT 59101-0127 | 2014-06-21 |
| 1972811768 | Providence Health & Services Mt | Surgery | 500 W Broadway St, Missoula, MT 59802-4008 | 2010-09-15 |
| 1023253044 | Marcus Daly Memorial Hospital Corporation | Surgery | 1150 Westwood Dr, Suite C, Hamilton, MT 59840-5318 | 2008-12-04 |
| 1053599407 | Robert J Hancock | Surgery | 801 N 29th St, Billings, MT 59101-0905 | 2008-02-07 |
| 1386829216 | William J Harper Md PC | Surgery | 400 Saddle Dr, Helena, MT 59601-5631 | 2008-01-09 |
| 1366627341 | Thomas F Beeson Md PC | Surgery | 2600 Wilson St, Miles City, MT 59301-5094 | 2008-01-08 |
| 1942414040 | Patrick Joshua O'brien | Surgery | 500 W Broadway St Ste 320, Missoula, MT 59802-4031 | 2007-05-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.