Provider Demographics
NPI:1356836944
Name:MENDOZA CESPEDES, JAYNEE MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:JAYNEE
Middle Name:MARIE
Last Name:MENDOZA CESPEDES
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 1:507 N HIGHWAY 77 STE 512
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1885
Mailing Address - Country:US
Mailing Address - Phone:469-501-2575
Mailing Address - Fax:
Practice Address - Street 1:507 N HIGHWAY 77 STE 512
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1885
Practice Address - Country:US
Practice Address - Phone:469-501-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108251223G0001X
TX34672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice