Provider Demographics
NPI:1285882563
Name:MENDEZ VIERA, BIANCA ANA (DMD)
Entity type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:ANA
Last Name:MENDEZ VIERA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 SW 143RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6584
Mailing Address - Country:US
Mailing Address - Phone:305-401-6591
Mailing Address - Fax:
Practice Address - Street 1:2723 SW 143RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6584
Practice Address - Country:US
Practice Address - Phone:305-401-6591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 184911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice