Provider Demographics
NPI:1093939316
Name:MENDOZA, JOSEPH RALPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RALPH
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BROADWAY ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-9502
Mailing Address - Country:US
Mailing Address - Phone:281-485-2231
Mailing Address - Fax:281-485-2290
Practice Address - Street 1:2800 BROADWAY ST
Practice Address - Street 2:SUITE I
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-9502
Practice Address - Country:US
Practice Address - Phone:281-485-2231
Practice Address - Fax:281-485-2290
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX172931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice