Provider Demographics
NPI:1366547887
Name:SAKAMAKI, MARK P (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:SAKAMAKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 PAOLI PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9695
Mailing Address - Country:US
Mailing Address - Phone:812-923-1500
Mailing Address - Fax:812-923-7706
Practice Address - Street 1:4801 PAOLI PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9695
Practice Address - Country:US
Practice Address - Phone:812-923-1500
Practice Address - Fax:812-923-7706
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011074A1223E0200X
KY83511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice