1629290846 NPI number — DR. SILVIA C HERNANDEZ D.D.S.

Table of content: DR. SILVIA C HERNANDEZ D.D.S. (NPI 1629290846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629290846 NPI number — DR. SILVIA C HERNANDEZ D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ
Provider First Name:
SILVIA
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629290846
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20640 AVENUE 164
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTERVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93257-9288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-783-9098
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
784 N PROSPECT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTERVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93257-1941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-783-9154
Provider Business Practice Location Address Fax Number:
559-783-9190
Provider Enumeration Date:
05/03/2007

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:  42283 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 723480 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: B42283-02 . This is a "HEALTHY FAMILIES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: G93690-01 . This is a "DENTI-CAL #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 2-42283 . This is a "DELTA DENTAL OF CALIFORNI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 42283 . This is a "DELTADENTAL AND ALL OTHER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 75003 . This is a "TULARE HEALTHY FAMILIES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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