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NPI Code Detail

MEDICARE: MRS. JESSICA ASHLEY MENDES CDA,RDH

MEDICARE: MRS. JESSICA ASHLEY MENDES CDA,RDH
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
1124Q00000XDental HygienistDH87433MA

General Provider Information

NPI Number : 1790554392
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA ASHLEY MENDES CDA,RDH
Provider Business Mailing Address
First Line : 41 CAPE RD
Second Line :
City : MILFORD
State : MA
Zip : 01757-3276
Country : US
Telephone Number : 508-634-3713
Fax Number : 508-634-3707
Provider Business Practice Location Address
First Line : 41 CAPE RD
Second Line :
City : MILFORD
State : MA
Zip : 01757-3276
Country : US
Telephone Number : 508-634-3713
Fax Number : 508-634-3707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2023
Last Update Date : 12/22/2023

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