Provider Demographics
NPI:1558744342
Name:MEJIA, ISABELLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ISABELLA
Middle Name:
Last Name:MEJIA
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 1:3212 BROOKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4713
Mailing Address - Country:US
Mailing Address - Phone:972-801-7618
Mailing Address - Fax:
Practice Address - Street 1:6760 ABRAMS RD STE 201
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0245
Practice Address - Country:US
Practice Address - Phone:469-890-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist