Provider Demographics
NPI:1356646350
Name:MENDOZA, MARGARITA (DDS)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14835 LITTLE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3476
Mailing Address - Country:US
Mailing Address - Phone:909-896-3913
Mailing Address - Fax:
Practice Address - Street 1:40620 WINCHESTER RD
Practice Address - Street 2:SUITE B
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5504
Practice Address - Country:US
Practice Address - Phone:909-896-3913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA600901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice