Rachel Lynn Mendazona, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D011571 Issued in AZ

Practice address

21001 N Tatum Blvd Ste 80-1690
Phoenix, AZ 85050-5233

Phone

(480) 419-9200

NPI assigned

Oct 7, 2022

Sex

Female

Sole proprietor

No

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 TX

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

Practice roles

Locations

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.

• Gila River Health Care Corporation

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Gila River Health Care

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  • Rural Acute Care Hospital
  • Maricopa, AZ
  • NPI 1386633915
  NPD
• Marketplace Smiles, LLP

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1518052216
  NPD (past)
• Stillwater Dental, LLC

  • Dentist
  • Bend, OR
  • NPI 1912477522
  NPD (past)

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1942925318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16204 SW VAQUEROS WAY",
            "city": "POWELL BUTTE",
            "state": "OR",
            "postal_code": "977530411",
            "telephone_number": "541-325-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 80-1690",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850505233",
            "telephone_number": "480-419-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDAZONA",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011571",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celeste Mena
• Muresuk Mena, MD
• Elizabeth Anne Menard, LPC
• Phillip I Menashe, M.D.
• Alyssa Mencini, D.M.D
• Elliot Mendelsohn, M.D.
• Deborah S. Mendelson, MD
• Jenny Mendelson, M.D.
• Jessica Menden
• Cole Fredrick Paul Mendenhall, MD

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.