Individual provider Active NPI

Cathy Mak, DMD

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1497475289
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107915 Issued in CA
Practice address
255 S Grand Ave Ste 204
Los Angeles, CA 90012-3035
Phone
(213) 620-5777
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 107915 CA Primary

Addresses

Primary practice location

255 S Grand Ave Ste 204
Los Angeles, CA 90012-3035

Mailing address

838 Scudder Way
Monterey Park, CA 91754-4765
Phone (626) 679-8521

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
107915CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Don Mungcal DDS Brentwood Inc. General Practice CurrentSince Oct 1, 2023 Accepting new patients
Don Mungcal, D.D.S., Inc. General Practice PastSince Sep 4, 2022 Accepting new patients

Locations

255 S Grand Ave
Ste 204
Los Angeles, CA 90012
Phone (213) 620-5777

Interoperability endpoints

  • Direct secure messaging: cathy.mak.p1@direct.cscla.nextgenshare.com

Organizations & group practices 2

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": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1497475289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 SCUDDER WAY",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544765",
            "telephone_number": "626-679-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S GRAND AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123035",
            "telephone_number": "213-620-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "CATHY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.