Healthcare Provider Details

I. General information

NPI: 1093643454
Provider Name (Legal Business Name): DULCE MENDOZA RDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KANDY MENDOZA RDA

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9833 N WOODROW AVE
FRESNO CA
93720-4668
US

IV. Provider business mailing address

9833 N WOODROW AVE
FRESNO CA
93720-4668
US

V. Phone/Fax

Practice location:
  • Phone: 559-974-0861
  • Fax:
Mailing address:
  • Phone: 559-974-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License NumberRDA100985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: