Jose Mendoza

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60772766 Issued in WA

Practice address

8921 Sandifur Pkwy Ste 102
Pasco, WA 99301-9596

Phone

(509) 302-2663

Fax

(509) 302-2462

NPI assigned

May 25, 2017

Last updated

Jul 26, 2023By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

Practice roles

Locations

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

• Jose Mendoza Professional Services

  • Dental Clinic/Center
  • Pasco, WA
  • NPI 1518748755
  NPD Authorized official
• Monarch Sleep Solutions LLC

  • Durable Medical Equipment & Medical Supplies
  • Pasco, WA
  • NPI 1790466555
  NPD Authorized official

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1366970048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 SANDIFUR PKWY",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993019596",
            "telephone_number": "509-302-2663",
            "fax_number": "509-302-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 SANDIFUR PKWY STE 102",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993019596",
            "telephone_number": "509-302-2663",
            "fax_number": "509-302-2462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Columbia Ave",
            "address_purpose": "LOCATION",
            "city": "Connell",
            "state": "WA",
            "postal_code": "993268702",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 S 8t hSt",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "98901",
            "country_code": "US",
            "telephone_number": "509-454-4143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Othello",
            "state": "WA",
            "postal_code": "993441846",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Government Rd",
            "address_purpose": "LOCATION",
            "city": "Mattawa",
            "state": "WA",
            "postal_code": "993495120",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60772766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF HEALTH. WASHINGTON STATE",
            "identifier": "DE60772766",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angeles Mendez, SS INTERPRETER
• Vanessa L Mendez, CPC
• Veronica Mendez
• Destiny D Mendoza
• Elizabeth Mendoza
• Maria G Mendoza, ICM CHW
• Maria Isabel Mendoza
• Nancy Mendoza
• Norma I Mendoza, CDP
• Nancy Carolina Menjivar

• General Practice Dentistry in Pasco, WA
• Providers in Pasco, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.