Tristan Eleazar Mendoza, DDS.

Primary specialty

DentistTaxonomy code 122300000X

License

59736 Issued in CA

Practice address

3000 Colby St
Ste. 302
Berkeley, CA 94705-2083

Phone

(510) 843-4450

NPI assigned

Jan 26, 2012

Last updated

Jan 26, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1801168547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 COLBY ST",
            "address_2": "STE. 302",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052083",
            "telephone_number": "510-843-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLBY ST",
            "address_2": "STE. 302",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052083",
            "telephone_number": "510-843-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "TRISTAN",
        "middle_name": "ELEAZAR",
        "name_prefix": "Dr.",
        "credential": "DDS.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Alan Melny, M.D.
• Kellie Melton, OD
• Roger B Mendelson, MD
• Adrian Mendez
• Alyssa Carleen Mendoza
• Madelyn Mengarelli
• Melinda Menke, MSN, FNP-C
• Isaac Mensah
• Mental Health & Wellness Now Telehealth, LLC
• Mental Health Association of Alameda County (Mhaac)

• Dentist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.