Individual provider Active NPI

Mark D. Maklin, DMD

  • Pediatric Dentistry
  • Tucson, AZ
National Provider Identifier
1609904879
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2008 Issued in AZ
Practice address
2370 N Wyatt Dr
Ste 110
Tucson, AZ 85712-2119
Phone
(520) 325-6991
Fax
(520) 325-7950
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2008 AZ Primary

Addresses

Primary practice location

2370 N Wyatt Dr
Ste 110
Tucson, AZ 85712-2119

Mailing address

2370 N Wyatt Dr
Ste 110
Tucson, AZ 85712-2119
Phone (520) 325-6991

Other identifiers 1

IdentifierTypeStateIssuer
1609904879OtherAZNPI

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
2008AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Maklin DMD Past Accepting new patients

Organizations & group practices 1

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1609904879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 N WYATT DR",
            "address_2": "STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122119",
            "telephone_number": "520-325-6991",
            "fax_number": "520-325-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 N WYATT DR",
            "address_2": "STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122119",
            "telephone_number": "520-325-6991",
            "fax_number": "520-325-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKLIN",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "2008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609904879",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.