Provider Demographics
NPI:1801802830
Name:MENDOZA, MARIA I (DDS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:I
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4010 SANDY BROOK DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1516
Mailing Address - Country:US
Mailing Address - Phone:512-219-9827
Mailing Address - Fax:512-219-5959
Practice Address - Street 1:4010 SANDY BROOK DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1516
Practice Address - Country:US
Practice Address - Phone:512-219-9827
Practice Address - Fax:512-219-5959
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX224371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry