Provider Demographics
NPI:1497870752
Name:MENDOZA, JOCELYN F (DMD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:F
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WEST 34TH ST #1203
Mailing Address - Street 2:
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2115
Mailing Address - Country:US
Mailing Address - Phone:121-294-7641
Mailing Address - Fax:
Practice Address - Street 1:110 WEST 34TH ST #1203
Practice Address - Street 2:
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10001-2115
Practice Address - Country:US
Practice Address - Phone:121-294-7641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0474941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice