Provider Demographics
NPI:1396921300
Name:MENDEZ, MARIA DEL CARMEN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 KEENELAND CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-3145
Mailing Address - Country:US
Mailing Address - Phone:407-855-6305
Mailing Address - Fax:
Practice Address - Street 1:12927 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6592
Practice Address - Country:US
Practice Address - Phone:407-855-6305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN154471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics