Mario Mendoza, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60217 Issued in CA

Practice address

847 Cascade CT W
The Dalles, OR 97058-4437

Phone

(503) 867-1668

NPI assigned

Mar 2, 2011

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: mmendoza@direct.westerndental.com

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1154629970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 CASCADE CT W",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970584437",
            "telephone_number": "503-867-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 CASCADE CT W",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970584437",
            "telephone_number": "503-867-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Michelle Melum, QMHA
• Patricia Rae Mendes
• Amanda Rose Mendez
• Kimberly Mendoza Segura
• Cara Mendoza
• Robert Mendoza
• Tzitlali Merchant-Trejo
• Michael C. Murat, D.D.S., P.C.
• Mid Columbia Health Services
• Mid-Columbia Center for Living

• General Practice Dentistry in The Dalles, OR
• Providers in The Dalles, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.