Healthcare Provider Details

I. General information

NPI: 1598140386
Provider Name (Legal Business Name): ZAHIRA MENDOZA D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 AVE ARTERIAL HOSTOS GALERIA I, SUITE 205
SAN JUAN PR
00918-5000
US

IV. Provider business mailing address

PO BOX 190831
SAN JUAN PR
00919-0831
US

V. Phone/Fax

Practice location:
  • Phone: 787-281-7237
  • Fax:
Mailing address:
  • Phone: 787-281-7237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3204
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: