Provider Demographics
NPI:1952312308
Name:MENDENHALL, JOHN T JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:MENDENHALL
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-2449
Mailing Address - Country:US
Mailing Address - Phone:412-276-2515
Mailing Address - Fax:412-276-4773
Practice Address - Street 1:33 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-2449
Practice Address - Country:US
Practice Address - Phone:412-276-2515
Practice Address - Fax:412-276-4773
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020749L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist