Stephen R Mackiw, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2476 Issued in NM

Practice address

3900 Eubank Blvd NE
Suite 4
Albuquerque, NM 87111-3465

Phone

(505) 298-6732

Fax

(505) 275-9976

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205948734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 EUBANK BLVD NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113465",
            "telephone_number": "505-298-6732",
            "fax_number": "505-275-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 EUBANK BLVD NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113465",
            "telephone_number": "505-298-6732",
            "fax_number": "505-275-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIW",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Noah Mackey, MD MPH
• Kimberly A Mackey, MD
• Shameka Mackey
• Tabitha Elaine Mackey, MSW
• Joyce L Mackinstry, LMFT
• Joana Macklin
• Peggy Cynthia Maclean
• Amy Macleod, CNM
• Emily Anne Macleod, R.N.
• William F Macmaster

• All providers in Albuquerque, NM
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.