Provider Demographics
NPI:1790554392
Name:MENDES, JESSICA ASHLEY (CDA,RDH)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ASHLEY
Last Name:MENDES
Suffix:
Gender:F
Credentials:CDA,RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CAPE RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3276
Mailing Address - Country:US
Mailing Address - Phone:508-634-3713
Mailing Address - Fax:508-634-3707
Practice Address - Street 1:41 CAPE RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3276
Practice Address - Country:US
Practice Address - Phone:508-634-3713
Practice Address - Fax:508-634-3707
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH87433124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist