Makenna Marie Vierck, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105050 Issued in CA

Practice address

450 Sutter St RM 2320
San Francisco, CA 94108-4209

Phone

(425) 397-2500

NPI assigned

Jul 21, 2020

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1568070910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 LYNCH RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949549526",
            "telephone_number": "480-205-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST RM 2320",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084209",
            "telephone_number": "425-397-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3580 California St Ste 204",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941181717",
            "country_code": "US",
            "telephone_number": "415-563-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIERCK",
        "first_name": "MAKENNA",
        "middle_name": "MARIE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Ryan Vidrine, M.D.
• Arpana R. Vidyarthi, MD
• Nitin Vidyasagar
• Rita Vieira Domingos
• Simone Vienneau
• Helena Louise Viets
• Julian Calvin Vigay II
• Angela Vigil
• Joserosario Vigil
• Lynda Vigil, L. AC.

• General Practice Dentistry in San Francisco, CA
• Providers in San Francisco, CA by specialty
• General Practice Dentistry in California

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