Provider Demographics
NPI:1891546560
Name:LIU MAKAN DOWNEY DENTAL CORPORATION
Entity Type:Organization
Organization Name:LIU MAKAN DOWNEY DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-872-8681
Mailing Address - Street 1:1908 RUE LE CHARLENE
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-6372
Mailing Address - Country:US
Mailing Address - Phone:310-872-8681
Mailing Address - Fax:
Practice Address - Street 1:10601 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3303
Practice Address - Country:US
Practice Address - Phone:562-459-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty