Provider Demographics
NPI:1851049308
Name:MENDEZ-FELICIANO, JAYNIZ NAZARIN (DMD)
Entity Type:Individual
Prefix:
First Name:JAYNIZ
Middle Name:NAZARIN
Last Name:MENDEZ-FELICIANO
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 1:55 PATRIOT CIR APT L
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-1685
Mailing Address - Country:US
Mailing Address - Phone:787-396-3029
Mailing Address - Fax:
Practice Address - Street 1:120 HOBART ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4308
Practice Address - Country:US
Practice Address - Phone:315-798-1149
Practice Address - Fax:315-734-3565
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0633211223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice