Active NPI
Maria I Mendoza, DDS
- Pediatric Dentistry
- Round Rock, TX
National Provider Identifier
1801802830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22437
- Practice address
- 4010 Sandy Brook Dr
Suite 106
Round Rock, TX 78665-1516 - Phone
- (512) 219-9827
- Fax
- (512) 219-5959
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 22437 | TX | Primary |
Addresses
Primary practice location
4010 Sandy Brook Dr
Suite 106
Round Rock, TX 78665-1516
Mailing address
4010 Sandy Brook Dr
Suite 106
Round Rock, TX 78665-1516
Phone (512) 219-9827
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22437 | TX | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids First Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Round Rock, TX
- NPI 1043549173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282867200000",
"number": "1801802830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 SANDY BROOK DR",
"address_2": "SUITE 106",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786651516",
"telephone_number": "512-219-9827",
"fax_number": "512-219-5959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 SANDY BROOK DR",
"address_2": "SUITE 106",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786651516",
"telephone_number": "512-219-9827",
"fax_number": "512-219-5959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "MARIA",
"middle_name": "I",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2010-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "22437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.