Provider Demographics
NPI:1235125899
Name:MENDEZ, HILDA M (DMD)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:M
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:576 CALLE CESAR GONZALEZ
Mailing Address - Street 2:STE 307
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3756
Mailing Address - Country:US
Mailing Address - Phone:787-753-1405
Mailing Address - Fax:787-753-1475
Practice Address - Street 1:576 CALLE CESAR GONZALEZ
Practice Address - Street 2:STE 307
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3756
Practice Address - Country:US
Practice Address - Phone:787-753-1405
Practice Address - Fax:787-753-1475
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
42345MEOtherSEGUROS DE SERVICIOS DE S
9180375OtherHUMANA INSURANCE
421199OtherUNITED CONCORDIA
26474OtherAMERICAN HEALTH
A312OtherINTERNATIONAL MEDICAL CAR