Fernanda Carla Mendoza Cervantes, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22D102985300 Issued in NJ

Practice address

66 Somme St
Newark, NJ 07105-3612

Phone

(973) 578-8788

NPI assigned

Jun 21, 2022

Last updated

Mar 22, 2025By the provider in NPPES

Sex

Female

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

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.

• Child Smiles Spec LLC

  dba Childsmiles

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Newark, NJ
  • NPI 1184099251

  Multi-Specialty

  NPD (past)
• Glen Shanock's Dentistry, PC

  dba Dr. Glen's Happy Teeth

  • Pediatric Dentistry
  • Long Beach, NY
  • NPI 1730628884
  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1487385423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 CENTER BLVD APT 3218",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095968",
            "telephone_number": "915-706-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SOMME ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053612",
            "telephone_number": "973-578-8788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 W Park Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115613301",
            "country_code": "US",
            "telephone_number": "516-431-5855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA CERVANTES",
        "first_name": "FERNANDA",
        "middle_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "064371",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22D102985300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahar Memar Montazerin, MD
• Priscille Meme
• Erika Michelle Mendez, RPH
• Jenniliz Mendez
• Dhruv Mendiratta, MD
• Maira Jocelyn Mendoza
• Kimberly Menjivar, RDH
• Leo Menkes, D.O.
• Sujoy Menon, MD
• Joshua Mensah

• Pediatric Dentistry in Newark, NJ
• Providers in Newark, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; 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.