Provider Demographics
NPI:1891850749
Name:MENDOZA, FRANK A (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 NE KIM LN
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6054
Mailing Address - Country:US
Mailing Address - Phone:541-317-0863
Mailing Address - Fax:541-317-0863
Practice Address - Street 1:WARM SPRINGS INDIAN HEALTH SERVICE DENTAL CLINIC
Practice Address - Street 2:1270 KOT-NUM ROAD
Practice Address - City:WARM SPRINGS
Practice Address - State:OR
Practice Address - Zip Code:97761
Practice Address - Country:US
Practice Address - Phone:541-553-2462
Practice Address - Fax:541-553-2619
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD74241223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry