Kenneth B Mak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41644 Issued in CA

Practice address

959 East Walnut St
Suite 216
Pasadena, CA 91106-5362

Phone

(626) 793-6175

Fax

(626) 793-9317

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mak and Kleiger, D.D.S.

  • General Practice Dentistry
  • Pasadena, CA
  • NPI 1275787210
  NPD (past) Authorized official

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881897130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 EAST WALNUT ST",
            "address_2": "SUITE 216",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911065362",
            "telephone_number": "626-793-6175",
            "fax_number": "626-793-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 EAST WALNUT ST",
            "address_2": "SUITE 216",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911065362",
            "telephone_number": "626-793-6175",
            "fax_number": "626-793-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "KENNETH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DNA",
            "identifier": "BM4155570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Maiden
• Alice Mailyan, FNP
• Kristofer John Maines, RN
• Sarah Mairesse
• Mak and Kleiger, D.D.S.
• Matthew Mak
• Nikki Wu Makino, M.S., CCC-SLP
• Martha Koyayawe Makundi
• Mona Malakouti
• Amanda Allyson Malave

• General Practice Dentistry in Pasadena, CA
• Providers in Pasadena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.