MEDICARE: DR. DANIEL MENDOZA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	0442	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902883465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL MENDOZA DPM

Provider Business Mailing Address
First Line	:	3024 BUSINESS PARK CIR
Second Line	:
City	:	GOODLETTSVILLE
State	:	TN
Zip	:	37072-3132
Country	:	US
Telephone Number	:	615-239-2018
Fax Number	:	615-452-8919

Provider Business Practice Location Address
First Line	:	353 NEW SHACKLE ISLAND RD STE 101A
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2329
Country	:	US
Telephone Number	:	615-822-9651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	09/05/2023

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