Karen Mak, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

101022 Issued in CA

Practice address

12455 Victoria Gardens LN Ste 190
Rancho Cucamonga, CA 91739-7534

Phone

(909) 463-7100

NPI assigned

Mar 12, 2013

Sex

Female

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• Budiman & Mak Dental Partnership

  • Pediatric Dentistry
  • Ontario, CA
  • NPI 1528702735
  NPD Authorized official

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1962743138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 VICTORIA GARDENS LN STE 190",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917397534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 VICTORIA GARDENS LN STE 190",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917397534",
            "telephone_number": "909-463-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "KAREN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60530097",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "101022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maher Azzawi DDS LLC
• Elise Mahill
• Colin Mahler
• Brian Patrick Mahorney, B.C.B.A.
• Dianna Mung-Fung Mak, DO
• Robert Maki, ND
• Making Life Wonderful (MLW), Inc
• Hetalben Makwana, MD
• Zozimo R Malana
• Claire Elizabeth Malawy, OTR/L

• Pediatric Dentistry in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.