Individual provider Active NPI

Ingmar Andrea Hernandez, DMD, MSD

  • Endodontics
  • Cape Coral, FL
National Provider Identifier
1538721006
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN24712 Issued in FL
Practice address
326 Del Prado Blvd N Ste 202
Cape Coral, FL 33909-2288
Phone
(239) 482-5311
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X UNAVAILABLE NY
Endodontics 1223E0200X DN24712 FL Primary

Addresses

Primary practice location

326 Del Prado Blvd N Ste 202
Cape Coral, FL 33909-2288

Mailing address

10002 Gulf Center Dr Ste 110
Fort Myers, FL 33913-8961
Phone (407) 683-1731

Other practice location 1

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7272

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

State licenses

LicenseStateTypeSpecialty
DN24712FLMDEndodontist
UNAVAILABLENYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Endodontics LLC Endodontics Current Accepting new patients
Steven M Frey DDS PA Endodontics PastSince Feb 18, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1538721006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10002 GULF CENTER DR STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138961",
            "telephone_number": "407-683-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 DEL PRADO BLVD N STE 202",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092288",
            "telephone_number": "239-482-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "374 Stockholm St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374006",
            "country_code": "US",
            "telephone_number": "718-963-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "INGMAR",
        "middle_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "UNAVAILABLE",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN24712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.