Active NPI
Jenna Mendoza
- Pharmacist
- Huron, SD
National Provider Identifier
1407443898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6821
- Practice address
- 100 Dakota Ave N # a
Huron, SD 57350-1630 - Phone
- (605) 352-9222
- NPI assigned
- Dec 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6821 | SD | Primary |
Addresses
Primary practice location
100 Dakota Ave N # a
Huron, SD 57350-1630
Mailing address
601 W 7TH Ave
Lennox, SD 57039-2421
Phone (605) 553-3822
Other names 1
- Jenna Cariddi
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6821 | SD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1407443898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W 7TH AVE",
"city": "LENNOX",
"state": "SD",
"postal_code": "570392421",
"telephone_number": "605-553-3822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DAKOTA AVE N # A",
"city": "HURON",
"state": "SD",
"postal_code": "573501630",
"telephone_number": "605-352-9222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-31",
"last_updated": "2020-12-31",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "6821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNA",
"last_name": "CARIDDI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Huron, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.