Healthcare Provider Details

I. General information

NPI: 1710508023
Provider Name (Legal Business Name): ALEXANDRA MAKARA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SOUTH DRIVE 122 ROCKLAND HALL
STONY BROOK NY
11794-8705
US

IV. Provider business mailing address

101 SOUTH DRIVE 122 ROCKLAND HALL
STONY BROOK NY
11794-0001
US

V. Phone/Fax

Practice location:
  • Phone: 631-632-8971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number062071
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: