Provider Demographics
NPI:1134598535
Name:SOTO-MENDEZ, JOSE (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:SOTO-MENDEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 E 34TH ST
Mailing Address - Street 2:APT 102
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2682
Mailing Address - Country:US
Mailing Address - Phone:305-323-9036
Mailing Address - Fax:
Practice Address - Street 1:2740 VALWOOD PKWY STE 144
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-3562
Practice Address - Country:US
Practice Address - Phone:972-746-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist