Mendieta, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30.022430 Issued in OH

Legal business name

MENDIETA, LLC

Practice address

3079 W Broad St Ste 6
Columbus, OH 43204-1397

Phone

(614) 279-6481

NPI assigned

Jun 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Edgar Yahir Mendieta, DDS

Title

Orthodontist

Phone

(310) 592-2057

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1851686562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3079 W BROAD ST STE 6",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041397",
            "telephone_number": "614-279-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3079 W BROAD ST STE 6",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041397",
            "telephone_number": "614-279-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDIETA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "MENDIETA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "YAHIR",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "310-592-2057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30.022430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3147286",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Mendez Perez
• Mynor Mendez Valdez, MD
• Aysha D Mendez, QMHS 3YRS CMS
• Robert William Mendicino, D.P.M.
• Edgar Y Mendieta, DDS
• Mendingoh
• Vivek Mendiratta, MD
• Anna Mendlein, MSW, LSW
• Janet Field Mendola, M.D.
• Lauren Mendonsa

• Orthodontics and Dentofacial Orthopedics Dentistry in Columbus, OH
• Providers in Columbus, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.