Individual provider Active NPI

Nathalia Hernandez, D.M.D.

  • Pediatric Dentistry
  • Bristol, CT
National Provider Identifier
1043074545
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14723 Issued in CT
Practice address
710 King St
Bristol, CT 06010-4477
Phone
(860) 583-8469
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 14723 CT Primary

Addresses

Primary practice location

710 King St
Bristol, CT 06010-4477

Mailing address

4338 Madison Ave
Trumbull, CT 06611-2716
Phone (203) 520-7245

Other practice location 1

435 Willard Ave Ste C
Newington, CT 06111-2378
Phone (860) 372-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nicklaus Children'S Hospital Student in an Organized Health Care Education/Training Program CurrentSince Feb 2, 2025 Accepting new patients
Tiny Teeth General Dentistry LLC Pediatric Dentistry Past Accepting new patients
Tiny Teeth Pediatric Dentistry PLLC Pediatric Dentistry PastSince Nov 6, 2022 Accepting new patients

Locations

3601 NW 107th Ave
Fl 3
Doral, FL 33178
Phone (305) 418-7771

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1043074545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4338 MADISON AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066112716",
            "telephone_number": "203-520-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KING ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104477",
            "telephone_number": "860-583-8469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Willard Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Newington",
            "state": "CT",
            "postal_code": "061112378",
            "country_code": "US",
            "telephone_number": "860-372-4600",
            "fax_number": "860-372-4602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "NATHALIA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "14723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.