Carlene a Mendieta DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DA34741 Issued in CA

Legal business name

CARLENE A MENDIETA DDS

Practice address

1420 Tara Hills Dr
#C
Pinole, CA 94564-2530

Phone

(510) 724-8441

Fax

(510) 724-0120

NPI assigned

Nov 30, 2005

Last updated

Jul 14, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Carlene A Mendieta, DDS

Title

Owner

Phone

(510) 724-8441

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Steven Meyers, DDS, MSD

  • Dentist
  • Pinole, CA
  • NPI 1659401057

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1780668020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 TARA HILLS DR",
            "address_2": "#C",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642530",
            "telephone_number": "510-724-8441",
            "fax_number": "510-724-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 TARA HILLS DR",
            "address_2": "#C",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642530",
            "telephone_number": "510-724-8441",
            "fax_number": "510-724-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLENE A MENDIETA DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "MENDIETA",
        "authorized_official_first_name": "CARLENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-724-8441",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "DA34741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DA34741",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Calixtro
• Canyon Pinole Surgery Center, LP
• John Henson Rivera Caparas, DO
• Maribel Rebekha Cardenas
• Dimitri Rizal Cardona
• Carolyn L. Yu, DDS, Inc
• Carolyn M. Lobo, M.D., Inc.
• Elizabeth Casey, DO
• Daisy Casias
• Manantial Casillas

• Periodontics in Pinole, CA
• Providers in Pinole, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.