Provider Demographics
NPI:1609762707
Name:MENDEZ TOLEDO, EUSDALIS (DMD)
Entity type:Individual
Prefix:
First Name:EUSDALIS
Middle Name:
Last Name:MENDEZ TOLEDO
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 1:2116 W FAIDLEY AVE STE 2100
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4602
Mailing Address - Country:US
Mailing Address - Phone:308-382-4297
Mailing Address - Fax:308-675-2825
Practice Address - Street 1:223 E 14TH ST STE 100
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3240
Practice Address - Country:US
Practice Address - Phone:402-519-5517
Practice Address - Fax:308-675-2825
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE81311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice