Provider Demographics
NPI:1073766077
Name:MENDENHALL, TODD (DMD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:MENDENHALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2927
Mailing Address - Country:US
Mailing Address - Phone:724-378-1000
Mailing Address - Fax:
Practice Address - Street 1:1921 MAIN ST
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2927
Practice Address - Country:US
Practice Address - Phone:724-378-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0355661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice