Individual provider Active NPI

Henrry Lazaro La Nuez Mendez, DMD

  • General Practice Dentistry
  • Homestead, FL
National Provider Identifier
1790417988
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26987 Issued in FL
Practice address
23238 SW 119TH Ave
Homestead, FL 33032-3069
Phone
(786) 552-2108
NPI assigned
Jun 27, 2022
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 26987 FL Primary

Addresses

Primary practice location

23238 SW 119TH Ave
Homestead, FL 33032-3069

Mailing address

23238 SW 119TH Ave
Homestead, FL 33032-3069
Phone (786) 552-2108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250806003303 FL Order and Referring Only - DentistPractitioner - Dentist 2961910245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26987FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1790417988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23238 SW 119TH AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330323069",
            "telephone_number": "786-552-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23238 SW 119TH AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330323069",
            "telephone_number": "786-552-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA NUEZ MENDEZ",
        "first_name": "HENRRY",
        "middle_name": "LAZARO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "26987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.