David Andres Mendoza

Primary specialty

DentistTaxonomy code 122300000X

License

DDS109877 Issued in CA

Practice address

82151 Avenue 42 Ste 110
Indio, CA 92203-9313

Phone

(760) 255-7597

NPI assigned

Oct 30, 2024

Last updated

Oct 30, 2024By 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

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

State licenses

Practice roles

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.

• Alexander Tran Dental Corporation

  dba Indio Modern Dentistry Dental Group

  • Dentist
  • Indio, CA
  • NPI 1356839484
  NPD (past)

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1447072400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82151 AVENUE 42 STE 110",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922039313",
            "telephone_number": "760-255-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82151 AVENUE 42 STE 110",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922039313",
            "telephone_number": "760-255-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "DAVID",
        "middle_name": "ANDRES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS109877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mildred Lotty Mendez-Andrews, ASSOC CLIN SOC WKR
• Makayla Marie Mendez-Torres
• Marisa Mendiola
• Miranda Mendiola
• Ana G Mendoza
• Herlinda Eva Mendoza, LVN
• Ismael Mendoza
• Jennifer Mendoza, SRN
• Martha Yadira Mendoza, LVN
• Mental Health Substance Abuse Program

• Dentist in Indio, CA
• Providers in Indio, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.