Ivan Cedeno Mendez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28329 Issued in FL

Practice address

4047 Okeechobee Blvd Ste 219
West Palm Beach, FL 33409-3237

Phone

(561) 640-7600

NPI assigned

Jul 6, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1053099598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 LARCH WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145101",
            "telephone_number": "512-903-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 OKEECHOBEE BLVD STE 219",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093237",
            "telephone_number": "561-640-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDENO MENDEZ",
        "first_name": "IVAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "28329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ceballos Cordero, DDS
• Micah Cecchetti
• Lisa Michelle Cecere, DPT
• Denise (Denny) J. Cecil-Van Den Heuvel, PH.D.
• Carlos E. Cedano
• Brenda Cedeno Rigol
• Robert F Cefola, RRT
• Calmie Ceide Joseph
• Norma Alicia Ceja, APRN
• Andre Celestin III, MD

• General Practice Dentistry in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.