Henry William Mercado, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27175 Issued in CA

Practice address

453 Cajon St
Suite a
Redlands, CA 92373-5979

Phone

(909) 793-0624

Fax

(909) 793-2467

NPI assigned

May 5, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1306164074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 CAJON ST",
            "address_2": "SUITE A",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735979",
            "telephone_number": "909-793-0624",
            "fax_number": "909-793-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 CAJON ST",
            "address_2": "SUITE A",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735979",
            "telephone_number": "909-793-0624",
            "fax_number": "909-793-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "HENRY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "27175",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Thomas Mendoza, PT
• Tiffany Darlene Mendoza, PA-C
• Xianai Meng, LAC
• Susan Menocal-Davis
• Szabolcs S Mera, M.D.
• Merito House, LLC
• Linda Metzger, PA
• Lizette Metzger
• Lisa Meyer-Angles, LCSW
• Kathryn M Michael

• General Practice Dentistry in Redlands, CA
• Providers in Redlands, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.