Provider Demographics
NPI:1144333949
Name:MAKKI, ALI (DMD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:MAKKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3900 W COAST HWY STE 330
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4093
Mailing Address - Country:US
Mailing Address - Phone:949-706-5581
Mailing Address - Fax:949-706-5583
Practice Address - Street 1:11370 ANDERSON ST STE B-100
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3450
Practice Address - Country:US
Practice Address - Phone:909-558-2880
Practice Address - Fax:909-558-2692
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA546071223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain