Individual provider Active NPI

Oluwatimilehin Makinde, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1407448590
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062527 Issued in NY
Practice address
1824 Madison Ave Dept of
New York, NY 10035-3832
Phone
(212) 423-4400
NPI assigned
Feb 9, 2021
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062527 NY Primary

Addresses

Primary practice location

1824 Madison Ave Dept of
New York, NY 10035-3832

Mailing address

1824 Madison Ave Dept of
New York, NY 10035-3832
Phone (212) 423-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230314001947 NY Practitioner - Dentist 8426422429 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062527NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Nov 18, 2022 Accepting new patients
The Floating Hospital Inc. CurrentSince Feb 5, 2025 Accepting new patients
The Floating Hospital Inc. CurrentSince Feb 5, 2025 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

1029 41st Ave
Long Island City, NY 11101
Phone (718) 361-6266

2101 41st Ave
Long Island City, NY 11101
Phone 7187842240144

1200 Brown St
Peekskill, NY 10566
Phone (845) 838-7020

Interoperability endpoints

  • Direct secure messaging: omakinde768082@nyumc.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1407448590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE DEPT OF",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE DEPT OF",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKINDE",
        "first_name": "OLUWATIMILEHIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-09",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.