Individual provider Active NPI

Rosa M Mendez, DDS

  • General Practice Dentistry
  • Hialeah, FL
National Provider Identifier
1780777359
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0012928 Issued in FL
Practice address
3822 West 16 Avenue
Hialeah, FL 33012
Phone
(305) 362-5559
Fax
(305) 362-2255
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN0012928 FL Primary

Addresses

Primary practice location

3822 West 16 Avenue
Hialeah, FL 33012

Mailing address

3822 West 16 Avenue
Hialeah, FL 33012
Phone (305) 362-5559

Other identifiers 1

IdentifierTypeStateIssuer
073712700MedicaidFL

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

LicenseStateTypeSpecialty
DN0012928FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780777359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 WEST 16 AVENUE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-362-5559",
            "fax_number": "305-362-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 WEST 16 AVENUE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-362-5559",
            "fax_number": "305-362-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "ROSA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0012928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073712700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.