Individual provider Active NPI

Sirish Makan, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Hayward, CA
National Provider Identifier
1821386285
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
65305 Issued in CA
Practice address
123 W Jackson St
Hayward, CA 94544-1809
Phone
(310) 872-8681
NPI assigned
Jul 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9353 TN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 65305 CA Primary

Addresses

Primary practice location

123 W Jackson St
Hayward, CA 94544-1809

Mailing address

123 W Jackson St
Hayward, CA 94544-1809
Phone (310) 872-8681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170614001122 CA Practitioner - Oral Surgery 6406144542 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Univ of the Pacific Dugoni School of Dentistry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Makan Tarzana Dental CorporationGroup PAC ID 1759765605, 4 clinicians
Makan Dental CorporationGroup PAC ID 6709256456, 5 clinicians

Practice addresses (Care Compare)

18372 Clark St
Suite 224
Tarzana, CA 91356-3559
Phone (818) 996-1200

5555 Truxtun Ave
Suite 200
Bakersfield, CA 93309-7451
Phone (661) 863-9995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9353TNMDDentist
65305CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Liu Makan Downey Dental Corporation Oral and Maxillofacial Surgery CurrentSince Apr 12, 2024 Accepting new patients
Makan Dental Corporation Oral and Maxillofacial Surgery CurrentSince Nov 4, 2022 Accepting new patients
Makan Tarzana Dental Corporation Oral and Maxillofacial Surgery CurrentSince Jun 8, 2022 Accepting new patients
1706 Sapana Kothary DDS Inc PastSince Oct 22, 2023 Accepting new patients

Locations

5555 Truxtun Ave
Ste 200
Bakersfield, CA 93309
Phone (661) 863-9995

10601 Paramount Blvd
Downey, CA 90241
Phone (562) 459-3311

18372 Clark St
Ste 224
Tarzana, CA 91356
Phone (818) 578-3500

Organizations & group practices 5

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1821386285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441809",
            "telephone_number": "310-872-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441809",
            "telephone_number": "310-872-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKAN",
        "first_name": "SIRISH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9353",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "65305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.