Nishant Makadia, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019033992 Issued in IL

Practice address

338 S Green Bay Rd
Waukegan, IL 60085-4850

Phone

(847) 336-7800

NPI assigned

Dec 12, 2022

Last updated

Dec 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waukegan Dental Care LLC

  • Dental Clinic/Center
  • Waukegan, IL
  • NPI 1265050959
  NPD

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1861103764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 S GREEN BAY RD UNIT 12",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854850",
            "telephone_number": "847-336-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 S GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854850",
            "telephone_number": "847-336-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKADIA",
        "first_name": "NISHANT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENCE NUMBER",
            "identifier": "019033992",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simon Mac
• Charles Mack
• Sean E Macphail
• Marianne T Madariaga, RN
• Leslie Stephanie Maitland-Mitchell
• Dustin Makela, LCPC
• Brianna Caitlin Maki, CCC-SLP
• Jane R Malalis, MD
• Vanessa Maldonado
• Pratibha Katyal Malhotra

• General Practice Dentistry in Waukegan, IL
• Providers in Waukegan, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.