NPIMap

Organization Active NPI

Mendes Family Dentistry

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1184899106
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MENDES FAMILY DENTISTRY
Practice address
550 Snelling Ave S
Saint Paul, MN 55116-1564
Phone
(651) 699-0404
Fax
(651) 699-9034
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Dr. Charles H Mendes, DDSNPI 1023097730
Title
Owner
Phone
(651) 699-0404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

550 Snelling Ave S
Saint Paul, MN 55116-1564

Mailing address

550 Snelling Ave S
Saint Paul, MN 55116-1564
Phone (651) 699-0404

Other identifiers 2

IdentifierTypeStateIssuer
481641200MedicaidMN
728815800MedicaidMN

National Provider Directory

National Provider Directory

Locations

550 Snelling Ave S
Saint Paul, MN 55116
Phone (651) 699-0404

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1184899106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161564",
            "telephone_number": "651-699-0404",
            "fax_number": "651-699-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161564",
            "telephone_number": "651-699-0404",
            "fax_number": "651-699-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDES FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "MENDES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-699-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "481641200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "728815800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.