Provider Demographics
NPI:1174639124
Name:COX, WENDELL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:A
Last Name:COX
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 1:8770 CUYAMACA ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4373
Mailing Address - Country:US
Mailing Address - Phone:619-449-6555
Mailing Address - Fax:
Practice Address - Street 1:8770 CUYAMACA ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4373
Practice Address - Country:US
Practice Address - Phone:619-449-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice