Active NPI
Anna Marie Mendoza
- Dental Assistant
- Long Beach, CA
National Provider Identifier
1831688050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 58250
- Practice address
- 1835 Ximeno Ave
Long Beach, CA 90815-2850 - Phone
- (562) 453-3409
- NPI assigned
- May 2, 2018
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 58250 | CA | Primary |
Addresses
Primary practice location
1835 Ximeno Ave
Long Beach, CA 90815-2850
Mailing address
13904 Ramhurst Dr Apt 11
La Mirada, CA 90638-1729
Phone (562) 324-7306
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 |
|---|---|---|---|
| 58250 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525219200000",
"number": "1831688050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13904 RAMHURST DR APT 11",
"city": "LA MIRADA",
"state": "CA",
"postal_code": "906381729",
"telephone_number": "562-324-7306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 XIMENO AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908152850",
"telephone_number": "562-453-3409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "ANNA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-02",
"last_updated": "2018-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "58250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.