Provider Demographics
NPI:1548840853
Name:MENDOZA CAVERO, MARIA CONCEPCION (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CONCEPCION
Last Name:MENDOZA CAVERO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 NW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4839
Mailing Address - Country:US
Mailing Address - Phone:786-294-2462
Mailing Address - Fax:
Practice Address - Street 1:7911 NW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-2227
Practice Address - Country:US
Practice Address - Phone:786-883-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-11
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL284081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice