Lidia A Mendoza, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42571 Issued in CA

Practice address

1511 W Holt Blvd Ste E
Ontario, CA 91762-3657

Phone

(909) 966-8877

NPI assigned

Apr 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1982667234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 BRENTWOOD AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864329",
            "telephone_number": "909-237-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 W HOLT BLVD STE E",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623657",
            "telephone_number": "909-966-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "LIDIA",
        "middle_name": "A",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42571",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL (PROVIDER NUMBE",
            "identifier": "B42571-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "330892867",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hector Mendoza Jr., PHARM.D.
• Irene Mendoza
• Joselyn Mendoza
• Karina Mendoza
• Lesliemarie Mendoza
• Lizette Casandra Mendoza, ACSW
• Maria Guadalupe Mendoza
• Mario Alberto Mendoza
• Michelle Isabella Mendoza, LVN
• Monique Arlinda Mendoza

• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.

Verify at the official NPI Registry.