Provider Demographics
NPI:1891599858
Name:MAKADIA DENTAL CORPORATION
Entity type:Organization
Organization Name:MAKADIA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKADIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-996-6951
Mailing Address - Street 1:2333 CAMINO DEL RIO S STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3600
Mailing Address - Country:US
Mailing Address - Phone:858-868-5501
Mailing Address - Fax:858-868-5502
Practice Address - Street 1:2333 CAMINO DEL RIO S STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3600
Practice Address - Country:US
Practice Address - Phone:858-868-5501
Practice Address - Fax:858-868-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty