Provider Demographics
NPI:1598523227
Name:SOFIA MENDEZ CARDENAS DDS PA
Entity Type:Organization
Organization Name:SOFIA MENDEZ CARDENAS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-326-6380
Mailing Address - Street 1:1605 TOWN CENTER BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3637
Mailing Address - Country:US
Mailing Address - Phone:954-385-0511
Mailing Address - Fax:954-389-5323
Practice Address - Street 1:1605 TOWN CENTER BLVD STE B
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3637
Practice Address - Country:US
Practice Address - Phone:954-385-0511
Practice Address - Fax:954-389-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental