Individual provider Active NPI

Makeba Sherron Earst, D.D.S.

  • General Practice Dentistry
  • Tallahassee, FL
National Provider Identifier
1740405042
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15394 Issued in FL
Practice address
2332 Centerville Rd
Tallahassee, FL 32308-4318
Phone
(850) 863-3333
Fax
(850) 386-3363
NPI assigned
Apr 13, 2007
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15394 FL Primary

Addresses

Primary practice location

2332 Centerville Rd
Tallahassee, FL 32308-4318

Mailing address

1716 Vineyard Way
Tallahassee, FL 32317-7913
Phone (850) 562-6835

Other identifiers 1

IdentifierTypeStateIssuer
076663100MedicaidFL

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
15394FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1740405042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 VINEYARD WAY",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323177913",
            "telephone_number": "850-562-6835",
            "fax_number": "850-562-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 CENTERVILLE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084318",
            "telephone_number": "850-863-3333",
            "fax_number": "850-386-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARST",
        "first_name": "MAKEBA",
        "middle_name": "SHERRON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "15394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076663100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.