Individual provider Active NPI

Demetra Makris Sifakis, DDS

  • Dentist
  • Madison, WI
National Provider Identifier
1689883548
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54486 Issued in CA
Practice address
3434 E. Washington Ave.
Madison, WI 53704-4155
Phone
(608) 443-5550
Fax
(608) 443-5554
NPI assigned
May 21, 2007
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54486 CA Primary

Addresses

Primary practice location

3434 E. Washington Ave.
Madison, WI 53704-4155

Mailing address

2901 West Beltline Hwy.
Ste. 120
Madison, WI 53713-4226
Phone (608) 443-5500

Other names 1

  • Dr. Demetra Vasilia Makris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20151231001615 WI Order and Referring Only - DentistPractitioner - Dentist 8921300377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54486CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1689883548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 WEST BELTLINE HWY.",
            "address_2": "STE. 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134226",
            "telephone_number": "608-443-5500",
            "fax_number": "608-441-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 E. WASHINGTON AVE.",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044155",
            "telephone_number": "608-443-5550",
            "fax_number": "608-443-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIFAKIS",
        "first_name": "DEMETRA",
        "middle_name": "MAKRIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEMETRA",
            "last_name": "MAKRIS",
            "middle_name": "VASILIA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.