Prashant P Makadia, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE 60022736 Issued in WA

Practice address

417 SW Sedgwick Rd
Suite 101
Port Orchard, WA 98367

Phone

(360) 329-4657

Fax

(360) 329-6121

NPI assigned

Jul 15, 2008

Last updated

Feb 18, 2011By the provider in NPPES

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 WA

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

Practice roles

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

• Northwest Dental Group PLLC

  • Dentist
  • Port Orchard, WA
  • NPI 1407625320
  NPD (past)

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1326202615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 SW SEDGWICK RD",
            "address_2": "SUITE 101",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "98367",
            "telephone_number": "360-471-1761",
            "fax_number": "360-329-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SW SEDGWICK RD",
            "address_2": "SUITE 101",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "98367",
            "telephone_number": "360-329-4657",
            "fax_number": "360-329-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKADIA",
        "first_name": "PRASHANT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60022736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse La Ray Wayne Lyons, SUDP
• Suzanne Michele Lysobey, ARNP
• Brad R. Mackinnon, M.D.
• Merideth Michelle Macrae, OTR/L
• Mary Wairimu Maina
• Drewett George Malidore, D.D.S.
• River Azariah Malone, MA, LMFT-A
• Chanpreet Kaur Mangat, M.D.
• James Lee Mange, LMP
• Many Paths Acupuncture, PC

• Dentist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.