Individual provider Active NPI

Sue Min Mak, DDS

  • Dentist
  • Cranston, RI
National Provider Identifier
1295266013
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857349 Issued in MA
Practice address
725 Reservoir Ave Ste 301B
Cranston, RI 02910-4451
Phone
(401) 415-0101
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857349 MA Primary

Addresses

Primary practice location

725 Reservoir Ave Ste 301B
Cranston, RI 02910-4451

Mailing address

679 Washington St Ste 3-314
Attleboro, MA 02703-8406
Phone (617) 501-9271

Other practice location 1

30 Man Mar Dr Ste 9
Plainville, MA 02762-2271
Phone (401) 515-5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20240910000193 RI Practitioner - Dentist 1355881087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Univ of the Pacific Dugoni School of Dentistry, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

725 Reservoir Ave
Suite 301B
Cranston, RI 02910-4451
Phone (401) 415-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1857349MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
New England Sleep Health LLC CurrentSince May 23, 2024 Accepting new patients

Locations

725 Reservoir Ave
Ste 301B
Cranston, RI 02910
Phone (401) 415-0101

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1295266013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 WASHINGTON ST STE 3-314",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027038406",
            "telephone_number": "617-501-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RESERVOIR AVE STE 301B",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104451",
            "telephone_number": "401-415-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Man Mar Dr Ste 9",
            "address_purpose": "LOCATION",
            "city": "Plainville",
            "state": "MA",
            "postal_code": "027622271",
            "country_code": "US",
            "telephone_number": "401-515-5893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAK",
        "first_name": "SUE MIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.