Provider Demographics
NPI:1912235862
Name:EMER J. MAKAPUGAY, D.D.S, INC.
Entity Type:Organization
Organization Name:EMER J. MAKAPUGAY, D.D.S, INC.
Other - Org Name:MAK DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:EMER
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAKAPUGAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-237-9396
Mailing Address - Street 1:5399 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-6106
Mailing Address - Country:US
Mailing Address - Phone:937-237-9396
Mailing Address - Fax:937-237-5393
Practice Address - Street 1:5399 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-6106
Practice Address - Country:US
Practice Address - Phone:937-237-9396
Practice Address - Fax:937-237-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3000764Medicaid