Derrick David Mendez, D.M.D.
Individual provider Active NPI General Practice Dentistry · Brierfield, AL
NPI 1689089906 · NPPES record last updated Aug 29, 2016
Key facts
- NPI
- 1689089906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6102 (AL)
- Practice address
- 19330 Highway 139
Brierfield, AL 35035-3658 - Phone
- (205) 665-2723
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150622002695 | AL | Order and Referring Only - Dentist |
0143531848 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6102 | AL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6102 | AL | Yes |
Addresses
Primary practice location
19330 Highway 139
Brierfield, AL 35035-3658
Mailing address
19330 Highway 139
Brierfield, AL 35035-3658
Phone (205) 665-2723
Other providers in Brierfield, AL
- Access Vision Mobile Eye Clinic
- Katherine Fuller
- Genesis Dental Group Brierfield PC
- Jamie Acre Rogers
- S.M. Mahan L.L.C
- The Bibb County Health Care Authority
- Treetop Transportation
All providers in Brierfield, AL · General Practice Dentistry in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.