Individual provider Active NPI

Craig Stanley Makishima, DDS

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1982779146
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
033627 Issued in CA
Practice address
1355 Florin Road
Suite 4
Sacramento, CA 95822-4231
Phone
(916) 422-2722
Fax
(916) 422-0351
NPI assigned
Nov 22, 2006
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 033627 CA Primary

Addresses

Primary practice location

1355 Florin Road
Suite 4
Sacramento, CA 95822-4231

Mailing address

930 Florin Rd
Suite 201
Sacramento, CA 95831-5001
Phone (916) 422-2722

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
I20160617001742 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799076980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033627CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1982779146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 FLORIN RD",
            "address_2": "SUITE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958315001",
            "telephone_number": "916-422-2722",
            "fax_number": "916-422-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 FLORIN ROAD",
            "address_2": "SUITE 4",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958224231",
            "telephone_number": "916-422-2722",
            "fax_number": "916-422-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKISHIMA",
        "first_name": "CRAIG",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "033627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.