Organization
GUY W MENDIVIL, D.D.S. PROFESSIONAL DENTAL CORPORATION
Active
Other names
Tri-City Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUY W MENDIVIL DDS (OWNER)
(760) 945-4692
Entity
Organization
Contact information
Practice address
3998 VISTA WAY SUITE B, OCEANSIDE, CA 92056
(760) 945-1420
(760) 945-4692
Mailing address
3998 VISTA WAY SUITE B, OCEANSIDE, CA 92056
(760) 945-1420
(760) 945-4692
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D29737
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93914-02
MEDI-CAL/DENTI-CAL
CA
01
—
G9391402
DENTI-CAL PROVIDER
CA
Enumeration date
05/14/2008
Last updated
07/01/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up