Individual provider Active NPI

Makeda R Jones, AEF

  • Dental Assistant
  • Santa Ana, CA
National Provider Identifier
1235377706
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
1388 Issued in CA
Practice address
2614 W Dahl LN
Santa Ana, CA 92704-3110
Phone
(310) 350-4046
NPI assigned
Jan 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 84981 CA
Dental Assistant 126800000X 1388 CA Primary

Addresses

Primary practice location

2614 W Dahl LN
Santa Ana, CA 92704-3110

Mailing address

2614 W Dahl LN
Santa Ana, CA 92704-3110
Phone (310) 350-4046

Other practice location 1

18700 Main St Ste 203
Huntington Beach, CA 92648-1714
Phone (714) 375-7222

Other identifiers 1

IdentifierTypeStateIssuer
84981OtherCACAMTC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
84981CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Serena T Ta Dental Corporation PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1235377706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 W DAHL LN",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927043110",
            "telephone_number": "310-350-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 W DAHL LN",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927043110",
            "telephone_number": "310-350-4046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18700 Main St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926481714",
            "country_code": "US",
            "telephone_number": "714-375-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "MAKEDA",
        "middle_name": "R",
        "credential": "AEF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "84981",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "1388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAMTC",
            "identifier": "84981",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.