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General NPI Number Information
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NPI Number | 1083799787
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Entity Type | Individual
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Provider Name | DEBORAH ANN MENDEL DDS
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 305 W 12TH AVE DENTAL FACULTY PRACTICE
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City | COLUMBUS
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State | OH
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Zip | 43210-1267
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Country | US
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Telephone | 614-292-7604
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Fax |
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Provider Business Mailing Address
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Address Line | 4151 GAVIN LN
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City | COLUMBUS
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State | OH
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Zip | 43220-4425
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Country | US
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Telephone | 614-451-8343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30-01874
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License Number State | OH
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