Active NPI
Yolanda M Hernandez, DDS
- General Practice Dentistry
- Phoenix, AZ
National Provider Identifier
1154308799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6215
- Practice address
- 5115 W Thomas Rd
Phoenix, AZ 85031-3944 - Phone
- (602) 233-3133
- Fax
- (602) 278-3139
- NPI assigned
- Dec 26, 2005
- Last updated
- Dec 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6215 | AZ | Primary |
Addresses
Primary practice location
5115 W Thomas Rd
Phoenix, AZ 85031-3944
Mailing address
415 N Grand Ave
Pueblo, CO 81003-3111
Phone (719) 546-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 917586 | Medicaid | AZ |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Squaw Peak Anesthesia Inc | Past | Accepting new patients | |
| Children's Medicaid Dental Clinic, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Children's Dental Clinic of W. Thomas Rd.
- General Practice Dentistry
- Phoenix, AZ
- NPI 1326025974
-
- Registered Nurse
- Tempe, AZ
- NPI 1134352925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386806400000",
"number": "1154308799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 N GRAND AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033111",
"telephone_number": "719-546-3333",
"fax_number": "719-546-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5115 W THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850313944",
"telephone_number": "602-233-3133",
"fax_number": "602-278-3139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "YOLANDA",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-26",
"last_updated": "2013-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "6215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "917586",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.