DR. MARY GODLEY MENDOZA (NPI# 1871667832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871667832 |
| Entity Type | Individual |
| Full Name | DR. MARY GODLEY MENDOZA |
| Credential | DMD |
| Practice Address |
501 N Indian Rd Smith River CA 95567-9509 |
| Practice Telephone | 4242987350 |
| Practice Fax Number | 5418887505 |
| Mailing Telephone | 4242987350 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 57049 | CA | Dental Providers |
| N | 122300000X | Dentist | D8554 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699803890 | Mary J Mendoza | Nurse Practitioner | 200 E Chisum St, Roswell, NM 88203-5406 | 2007-03-01 |
| Street Address |
501 N INDIAN RD |
| City | SMITH RIVER |
| State | CA |
| Zip Code | 95567-9509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285638106 | Kirk John Petersen | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2005-06-09 |
| 1821440371 | United Indian Health Services, Inc. | Clinic/Center | 501 N Indian Rd, Smith River, CA 95567-9509 | 2016-07-08 |
| 1518157866 | John D. Wassenmiller | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2007-08-01 |
| 1104803147 | Vincent Tran | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2005-12-30 |
| 1518944578 | Wilmer Hechanova | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2005-12-29 |
| 1629055603 | Robert Weichers | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2005-12-29 |
| 1568460665 | Chad Gagnon | Physician Assistant | 501 N Indian Rd, Smith River, CA 95567-9509 | 2005-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598977597 | Russell Arthur Nickels | General Practice | 415 Highland Ave., Smith River, CA 95567 | 2007-05-04 |
| 1023239191 | Helena Joann Vipond | General Practice | 415 Highland Avenue, Smith River, CA 95567 | 2007-05-02 |
| 1487869566 | Dwight Walter Winslow | Internal Medicine | 205 Knutsen Ln, Smith River, CA 95567-9357 | 2007-05-11 |
| 1750406674 | Michael Arnold Moss | Dentist | 17295 Hiway 101 N, Smith River, CA 95567-9406 | 2007-03-20 |
| 1669852968 | The Wellness Center | Acupuncturist | 415 Highland Ave, Smith River, CA 95567-9519 | 2015-06-02 |
| 1851901045 | Rodney Martin Brim | Psychologist | 301 Nautical Hts, Smith River, CA 95567-9568 | 2020-08-03 |
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285638106 | Kirk John Petersen | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2005-06-09 |
| 1518157866 | John D. Wassenmiller | Dentist | 501 N Indian Rd, Smith River, CA 95567-9509 | 2007-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447057 | Sienna Palmer Ogbevoen Dds, Inc. | Dentist | 27871 Medical Center Rd Ste 290, Mission Viejo, CA 92691-6440 | 2020-11-07 |
| 1821699737 | William Bill Ngo | Dentist | 1591 Griffin Road Mcagcc, Twentynine Palms, CA 92277 | 2020-11-06 |
| 1134720022 | Iee Shin | Dentist | 30406 Haun Rd Ste 740, Menifee, CA 92584-6816 | 2020-11-05 |
| 1568063634 | Western Dental Services, Inc. | Dentist | 2537 S Euclid Ave Ste A, Ontario, CA 91762-6620 | 2020-11-05 |
| 1467053660 | Gurjot Sidhu Dds Dental Corporation | Dentist | 2701 E Hammer Ln Ste 101, Stockton, CA 95210-4245 | 2020-11-04 |
| 1821699133 | Ayesha Ahmad | Dentist | 4910 Chapparal Way, Banning, CA 92220-3353 | 2020-11-03 |
| 1407457856 | Yiyang Zou | Dentist | 333 W El Camino Real Ste 260, Sunnyvale, CA 94087-8127 | 2020-11-03 |
| 1851992481 | Centinela Joseph Dental Group | Dentist | 6907 La Tijera Blvd, Los Angeles, CA 90045-1906 | 2020-11-02 |
| 1518568138 | Raime Shah | Dentist | 707 Parnassus Ave Ste D-3000, San Francisco, CA 94143-2210 | 2020-11-02 |
| 1558961359 | Tony Tataro | Dentist | 5700 Village Oaks Dr Apt 1222, San Jose, CA 95123-3771 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | SMITH RIVER |
| Zip Code | 95567 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.