1700774643 NPI number — DR. ADRIANA FERNANDA MENDEZ-FRANCIA DMD

Table of content: DR. ADRIANA FERNANDA MENDEZ-FRANCIA DMD (NPI 1700774643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700774643 NPI number — DR. ADRIANA FERNANDA MENDEZ-FRANCIA DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MENDEZ-FRANCIA
Provider First Name:
ADRIANA
Provider Middle Name:
FERNANDA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MENDEZ-FRANCIA
Provider Other First Name:
ADRIANA
Provider Other Middle Name:
FERNANDA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700774643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6453 W 81ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60459-1701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-513-0696
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 NE GLEN OAK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEORIA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61637-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-624-4012
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  019.036081 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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