Individual provider Active NPI

Marlene Mendez, DMD

  • Dentist
  • North Myrtle Beach, SC
National Provider Identifier
1336337047
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4406 Issued in SC
Practice address
1240 Highway 17 South
North Myrtle Beach, SC 29582-3707
Phone
(843) 663-1033
Fax
(843) 663-3303
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18004 FL
Dentist 122300000X 4406 SC Primary

Addresses

Primary practice location

1240 Highway 17 South
North Myrtle Beach, SC 29582-3707

Mailing address

PO Box 547
Little River, SC 29566-0547
Phone (843) 663-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4406SCMDDentist
18004FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Medical Center, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1336337047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-1033",
            "fax_number": "843-663-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 17 SOUTH",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823707",
            "telephone_number": "843-663-1033",
            "fax_number": "843-663-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "MARLENE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "18004",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.