Healthcare Provider Details

I. General information

NPI: 1942111091
Provider Name (Legal Business Name): ALBERT MENDEZ DSS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 N BROADWAY ST
PITTSBURG KS
66762-3020
US

IV. Provider business mailing address

1510 N BROADWAY ST
PITTSBURG KS
66762-3020
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-6070
  • Fax:
Mailing address:
  • Phone: 620-231-6070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALBERT MENDEZ
Title or Position: PRESIDENT
Credential: DDS
Phone: 620-687-1096