Provider Demographics
NPI:1427326412
Name:MAYORA MEJIA, MARIANA (DDS)
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:MAYORA MEJIA
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 1:3525 DEL MAR HEIGHTS RD # 288
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2199
Mailing Address - Country:US
Mailing Address - Phone:858-518-9102
Mailing Address - Fax:
Practice Address - Street 1:8341 LA MESA BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0217
Practice Address - Country:US
Practice Address - Phone:619-464-4242
Practice Address - Fax:619-464-6587
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA581251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice