Faddy A Makaryus, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 18949 Issued in FL

Practice address

17531 N Dale Mabry Hwy
Lutz, FL 33548-4521

Phone

(813) 444-5060

NPI assigned

Jun 12, 2007

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 FL

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 and National Provider Directory roles.

• Coast Florida P.a.

  dba Coast Dental-Clearwater

  • Dentist
  • Clearwater, FL
  • NPI 1437725751
  NPD (past)
• Coast Florida P.a.

  • Dentist
  • Tampa, FL
  • NPI 1730287673
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1558565796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17531 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484521",
            "telephone_number": "813-444-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17531 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484521",
            "telephone_number": "813-444-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKARYUS",
        "first_name": "FADDY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya V Maharana, SLP
• Richa Mahatme, DDS
• Mahesh Bhambore MD PA (Sunstate Medical Clinic)
• Gabrielle Mai, APRN
• Phoebe Aimel Maisto, LMHC
• Kevin J. Makati, MD
• Viba Bhuvana Malaiyandi, MD
• Jessica Malave, MSN, APRN, FNP-BC
• Padmavathi Malempati, M.D.
• Jamie A Mallah, MD

• General Practice Dentistry in Lutz, FL
• Providers in Lutz, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.