Provider Demographics
NPI:1417572686
Name:MENDUS, CAROLINE (OD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:MENDUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 W 60TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-1318
Mailing Address - Country:US
Mailing Address - Phone:816-799-6992
Mailing Address - Fax:
Practice Address - Street 1:13900 E US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5860
Practice Address - Country:US
Practice Address - Phone:816-478-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020015761152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist