Baltazar Mendoza, R.D.A

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

68051 Issued in CA

Practice address

7691 El Chaco Drive
Buena Park, CA 90620

Phone

(562) 912-8307

NPI assigned

Jan 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1942531447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7691 EL CHACO DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906201807",
            "telephone_number": "562-912-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 EL CHACO DRIVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "90620",
            "telephone_number": "562-912-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "BALTAZAR",
        "credential": "R.D.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "68051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DENTAL BOARD",
            "identifier": "68051",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medsacu
• Megalife, Inc.
• Melissa Melara, PPS
• Melinda R. Menchavez, PT
• Anahi Lizbeth Gamino Mendoza, FNP
• Heidi Mendoza
• Dustin Mercado, PT, DPT
• Mercedes B Samson, M.D., Inc.
• Nicole Merizan-Aguayo, ASCWS
• Mariegrace Mero, R.N.

• Dental Assistant in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Dental Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.