Individual provider Active NPI

Gabriel Hernandez, D.D.S

  • Dentist
  • Pensacola, FL
National Provider Identifier
1093956088
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19082 Issued in FL
Practice address
1295 W Fairfield Dr
Pensacola, FL 32501-1107
Phone
(850) 912-8880
Fax
(850) 912-8779
NPI assigned
Mar 20, 2009
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6105 LA
Dentist 122300000X DN19082 FL Primary

Addresses

Primary practice location

1295 W Fairfield Dr
Pensacola, FL 32501-1107

Mailing address

2315 W Jackson St
Pensacola, FL 32505-7552
Phone (850) 436-4630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210527000412 TX Practitioner - Dentist 9436453149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6105LAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince May 3, 2021 Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1093956088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W JACKSON ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325057552",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 W FAIRFIELD DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011107",
            "telephone_number": "850-912-8880",
            "fax_number": "850-912-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6105",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.