Deviprasad M Makonahally, BDS MSC

Primary specialty

DentistTaxonomy code 122300000X

License

9482 Issued in MA

Practice address

73 Russell Rd
Huntington, MA 01050-9777

Phone

(413) 667-3009

Fax

(413) 667-8746

NPI assigned

Sep 26, 2007

Last updated

Sep 26, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MA

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

Interoperability endpoints

• Direct secure messaging: dmakonahally20022@direct.ctc.masshiway.net

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1508053216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 RUSSELL RD",
            "city": "HUNTINGTON",
            "state": "MA",
            "postal_code": "010509777",
            "telephone_number": "413-667-3009",
            "fax_number": "413-667-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 RUSSELL RD",
            "city": "HUNTINGTON",
            "state": "MA",
            "postal_code": "010509777",
            "telephone_number": "413-667-3009",
            "fax_number": "413-667-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKONAHALLY",
        "first_name": "DEVIPRASAD",
        "middle_name": "M",
        "credential": "BDS MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "9482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha M Klaczak, LMHC, LADCI, CADACII
• Doreen Michele Kruger
• Debra A Lavoice, RN
• Karen Levine, MSW
• Frances Lin, LCSW
• Kellyann Alexandria McKenzie, MASSAGE THERAPIST
• Jessica Marie Millett, A.P.R.N.
• Deanna Nappi, RD, LDN
• Carol L Owen, PH.D., LICSW
• Courtney Preston

• Dentist in Huntington, MA
• Providers in Huntington, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.