Provider Demographics
NPI:1912083940
Name:MENENDEZ, ANA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:MENENDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11272 N.W. 79 LANE
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178
Mailing Address - Country:US
Mailing Address - Phone:305-717-6896
Mailing Address - Fax:
Practice Address - Street 1:4301 PALM AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4060
Practice Address - Country:US
Practice Address - Phone:305-362-8089
Practice Address - Fax:305-362-4224
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 16397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist