Juan Carlos Mendoza Iglesias, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN23115 Issued in FL

Practice address

3801 Hollywood Blvd Ste 225
Hollywood, FL 33021-6849

Phone

(954) 246-4851

NPI assigned

Nov 20, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

State licenses

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821326430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 GROVE PARK DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323113616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 HOLLYWOOD BLVD STE 225",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216849",
            "telephone_number": "954-246-4851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Plaza Carolina Shopping Court",
            "address_2": "Suite 30",
            "address_purpose": "LOCATION",
            "city": "Carolina",
            "state": "PR",
            "postal_code": "00983",
            "country_code": "US",
            "telephone_number": "787-636-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Plaza Carolina Shopping Court",
            "address_2": "Suite 30",
            "address_purpose": "LOCATION",
            "city": "Carolina",
            "state": "PR",
            "postal_code": "00983",
            "country_code": "US",
            "telephone_number": "787-636-8184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA IGLESIAS",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "2848",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN23115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla Corinne Mendenhall, BSN
• Bella Gleiser Mendez, APRN
• Mikaela Mendez, PA-C
• Erick Manuel Mendieta, ARNP
• Jose Antonio Mendieta, APRN
• Kattys Elena Mendoza
• Laura Mendoza
• Aldo Menendez Arcia, PHYSICIAN ASSISTANT
• Lidaimis Lazara Menendez Prieto
• Meraki Clinical Group

• Periodontics in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.