E.Wendy Hernandez, DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

56388 Issued in CA

Legal business name

E.WENDY HERNANDEZ, DDS, INC

Doing business as

Heavenly Kids Dental

Practice address

1210 N Long Beach Blvd Ste 196
Compton, CA 90221-1685

Phone

(424) 785-8708

Fax

(424) 785-8718

NPI assigned

Aug 24, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Elsa Wendy Hernandez, DDS

Title

Owner/President

Phone

(619) 251-1312

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Heavenly Kids Dental Doing business as

Locations

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1053866517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12920 RUNWAY RD UNIT 310",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942313",
            "telephone_number": "424-785-8708",
            "fax_number": "424-785-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 N LONG BEACH BLVD STE 196",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902211685",
            "telephone_number": "424-785-8708",
            "fax_number": "424-785-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.WENDY HERNANDEZ, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ELSA",
        "authorized_official_middle_name": "WENDY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "619-251-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "56388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1497938401",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELSA W HERNANDEZ, DDS, INC",
            "identifier": "1437580644",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heavenly Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Compton, CA
• Providers in Compton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.