Edgar Y Mendieta, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30.022430 Issued in OH

Practice address

3160 W Broad St # 2300374
Columbus, OH 43204-1310

Phone

(614) 279-6481

Fax

(614) 279-0199

NPI assigned

Mar 17, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1437458346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041310",
            "telephone_number": "614-230-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 W BROAD ST # 2300374",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041310",
            "telephone_number": "614-279-6481",
            "fax_number": "614-279-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIETA",
        "first_name": "EDGAR",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-17",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "022430",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30.022430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanon Lea Mendes, LISW
• Abigail Mendez Perez
• Mynor Mendez Valdez, MD
• Aysha D Mendez, QMHS 3YRS CMS
• Robert William Mendicino, D.P.M.
• Mendieta, LLC
• Mendingoh
• Vivek Mendiratta, MD
• Anna Mendlein, MSW, LSW
• Janet Field Mendola, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Columbus, OH
• Providers in Columbus, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.