Active NPI
Benjamin Mendoza
- Dental Hygienist
- San Jose, CA
National Provider Identifier
1457781320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 26763
- Practice address
- 2195 Monterey Hwy Ste 30
San Jose, CA 95125-1069 - Phone
- (408) 295-1100
- NPI assigned
- Nov 13, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 26763 | CA | Primary |
Addresses
Primary practice location
2195 Monterey Hwy Ste 30
San Jose, CA 95125-1069
Mailing address
320 Shadow Run Dr
San Jose, CA 95110-3556
Phone (408) 896-3164
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 |
|---|---|---|---|
| 26763 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aulakh Dental Corporation | 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": "1384300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384300800000",
"number": "1457781320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 SHADOW RUN DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951103556",
"telephone_number": "408-896-3164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2195 MONTEREY HWY STE 30",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951251069",
"telephone_number": "408-295-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "BENJAMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-13",
"last_updated": "2013-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "26763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.