Stewart S Markofsky, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901012305 Issued in MI

Practice address

3326 Fort St
Lincoln Park, MI 48146-3627

Phone

(313) 381-0343

Fax

(313) 386-0331

NPI assigned

Jun 9, 2007

Last updated

Jun 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lincoln Park Family Dentistry DDS PC

  • Dentist
  • Lincoln Park, MI
  • NPI 1649371121
  NPD (past) Authorized official

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1932302528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463627",
            "telephone_number": "313-381-0343",
            "fax_number": "313-386-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463627",
            "telephone_number": "313-381-0343",
            "fax_number": "313-386-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKOFSKY",
        "first_name": "STEWART",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12305",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waseem Nidal Makki, D.D.S.
• Ankita S Mali, RPT
• Shashi Kanta Malik, M.D.
• Nicole Manthei, LLMSW
• Kelly Ann Marietti, LBSW, CAADC
• Shahetia Adedra Marsh, LLC
• Kathleen Ellen Martin IX, R.N.
• Eleonora Marza
• Deja Mason
• Sandra Kay Mastrogiacomo

• General Practice Dentistry in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.