Mario Hernandez, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0013087 Issued in FL

Practice address

1870 Forest Hill Blvd
Suite 103
Lake Clarke Shores, FL 33406-8901

Phone

(561) 585-5891

Fax

(561) 586-6014

NPI assigned

May 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mario Hernadez, DDS, Inc

  • Dental Clinic/Center
  • Lake Clarke Shores, FL
  • NPI 1417098260
  NPD Authorized official

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1487820296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 FOREST HILL BLVD",
            "address_2": "SUITE 103",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "334068901",
            "telephone_number": "561-585-5891",
            "fax_number": "561-586-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 FOREST HILL BLVD",
            "address_2": "SUITE 103",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "334068901",
            "telephone_number": "561-585-5891",
            "fax_number": "561-586-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-01",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0013087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janae Hardy
• Forrest P Harvey Jr., D.C
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• Megan Heller
• Liset Hernandez Pacin
• Vanessa Hevia
• Infinity Solutions Treatment Center Inc.
• Israel Machin MD PA
• Adrian Lynn James
• Mara Judith Kullman

• General Practice Dentistry in Lake Clarke Shores, FL
• Providers in Lake Clarke Shores, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.