Sebastian Mendoza

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02676600 Issued in NJ

Practice address

447 Route 10 E Ste 5
Randolph, NJ 07869-2132

Phone

(973) 328-1555

NPI assigned

Apr 28, 2017

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment
• Randolph Center for Oral and Maxillofacial Surgery, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Randolph, NJ
  • NPI 1003860578
  NPD
• Randolph Oral Pathology Associates, LLC

  • Oral and Maxillofacial Pathology Dentistry
  • Randolph, NJ
  • NPI 1053745117
  NPD

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1821523754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 ROUTE 10 E STE 5",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 ROUTE 10 E STE 5",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692132",
            "telephone_number": "973-328-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "SEBASTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02676600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiva Mehta, MD
• Kenneth William Meisner, M.D., F.A.C.S.
• Nancy Enid Mejias-Cepeda, RN
• Brittany Mekeel, L.A.C
• Bonnie J Mele, LCSW BCD
• Shirley Mensah
• Lauren Mary Merli, PHARMD
• Melissa Mielczarek
• Kenneth D Miller, MD
• Stuart H. Miller, MD

• Oral and Maxillofacial Surgery (Dentist) in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.