Individual provider Active NPI

Roland Anthony Hernandez, DDS.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Lauderdale, FL
National Provider Identifier
1427259431
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN16358 Issued in FL
Practice address
2000 S Andrews Avenue
Fort Lauderdale, FL 33316
Phone
(954) 356-9956
Fax
(954) 356-8120
NPI assigned
May 29, 2007
Last updated
Apr 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN16358 FL Primary

Addresses

Primary practice location

2000 S Andrews Avenue
Fort Lauderdale, FL 33316

Mailing address

2000 S Andrews Avenue
Fort Lauderdale, FL 33316
Phone (954) 356-9956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000146 FL Practitioner - Maxillofacial Surgery 6709054182 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN16358FLMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Lauderdale DMS Oral and Maxillofacial Surgery CurrentSince May 11, 2011 Accepting new patients

Locations

1625 SE 3rd Ave
Ste 802
Ft Lauderdale, FL 33316
Phone (954) 262-7500

2000 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 356-9956

Organizations & group practices 1

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1427259431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S ANDREWS AVENUE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-356-9956",
            "fax_number": "954-356-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S ANDREWS AVENUE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-356-9956",
            "fax_number": "954-356-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ROLAND",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN16358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.