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DR. MENDOZA'S PEDIATRIC AND ADOLSCENT
NPI 1295908101
Pediatrics - Adolescent Medicine in Jackson, KY

Active since April 11, 2008
424 JETT DR, JACKSON, KY 41339(606) 693-4800(606) 693-4825 Get Directions Write a Review

NPPES record last updated: July 10, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mendoza's Pediatric And Adolscent NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MENDOZA'S PEDIATRIC AND ADOLSCENT (NPI 1295908101) is a healthcare organization registered as an adolescent medicine in Jackson, Kentucky and active in the NPI registry since April 2008. The organization lists Edgar Allen Mendoza, Owner, as its authorized official.

NPPES Registry Identity

NPI1295908101
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameDR. MENDOZA'S PEDIATRIC AND ADOLSCENT
Location Address424 JETT DRJackson, KY 41339-9621
Mailing AddressPo Box 790Jackson, KY 41339-0790 · (606) 693-4800 · Fax (606) 693-4825
Phone(606) 693-4800
Fax(606) 693-4825
Organization SubpartNo
Authorized OfficialEdgar Allen MendozaOwner · (606) 693-4800
Enumeration DateApril 11, 2008
Last NPPES UpdateJuly 10, 2014
✔ NPI 1295908101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in KY · 33465
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
424 JETT DR, Jackson, KY 41339
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Other Identifiers 1

Medicaid31000979KY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GEORGE EDWARD BURNETTE MD
Family Medicine
424 JETT DR
JACKSON, KY 41339
Breathitt County (606) 666-6000
REBECCA MAE HOLBROOK APRN
Nurse Practitioner (Family)
424 JETT DR
JACKSON, KY 41339
Breathitt County (606) 666-6600
JACKSON PHYSICIAN CORP
Durable Medical Equipment & Medical Supplies
424 JETT DR
JACKSON, KY 41339
Breathitt County (606) 666-5354
JACKSON PHYSICIAN CORP
General Practice
424 JETT DR
JACKSON, KY 41339
Breathitt County (066) 936-4830
JACKSON HOSPITAL CORPORATION
Clinic/Center (Rural Health)
424 JETT DR
JACKSON, KY 41339
Breathitt County (606) 666-6600
KENTUCKY RIVER PHYSICIAN CORPORATION
Clinic/Center (Rural Health)
424 JETT DR
JACKSON, KY 41339
Breathitt County (606) 666-6600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dr. Mendoza's Pediatric And Adolscent's NPI number?

The NPI number for Dr. Mendoza's Pediatric And Adolscent is 1295908101. It was assigned to this organization in the NPPES registry on April 11, 2008.

Where is Dr. Mendoza's Pediatric And Adolscent located?

Dr. Mendoza's Pediatric And Adolscent is located at 424 Jett Dr, Jackson, KY 41339. The listed phone number is (606) 693-4800.

What is Dr. Mendoza's Pediatric And Adolscent's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

When was this NPI record last updated?

The NPPES record for Dr. Mendoza's Pediatric And Adolscent was last updated on July 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.