Organization · Type 2 NPI

Indira Vivian Medina Maycott

General Practice Dentistry · Tijuana, MX

NPI number 1508739871 Active

Practice location

Av De Los Olivos 200
Tijuana, MX 22045

Map

Mailing address

1415 Manzana Way
San Diego, CA 92139-4048

Specialties and licenses

TaxonomyCodeLicense
Endodontics 1223E0200XNone listed
General Practice Dentistry Primary 1223G0001XNone listed
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400XNone listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1508739871

Indira Vivian Medina Maycott's National Provider Identifier is 1508739871, issued on Sep 24, 2025. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Tijuana, MX. The record was last updated on Sep 24, 2025.