Individual provider Active NPI

Janice Hernandez-Diaz, DMD

  • Dentist
  • Mansfield, TX
National Provider Identifier
1548656978
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32889 Issued in TX
Practice address
3000 E Broad St
Ste 108
Mansfield, TX 76063-6696
Phone
(682) 341-0058
Fax
(682) 341-0063
NPI assigned
Apr 13, 2015
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 32889 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

3000 E Broad St
Ste 108
Mansfield, TX 76063-6696

Mailing address

PO Box 860036 Minneapolis
Minneapolis, MN 55486-0001
Phone (817) 842-2600

Other practice location 1

3806 E Broad St Ste 108
Mansfield, TX 76063-5621
Phone (817) 842-2600

Other practice location 2

111 E 210th St
Montefiore Medical Center
Bronx, NY 10467-2401
Phone (718) 920-4806

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
32889TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Network Provider Associates, P.C. Dentist Past Accepting new patients

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1548656978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860036 MINNEAPOLIS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860001",
            "telephone_number": "817-842-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 E BROAD ST",
            "address_2": "STE 108",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636696",
            "telephone_number": "682-341-0058",
            "fax_number": "682-341-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3806 E Broad St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760635621",
            "country_code": "US",
            "telephone_number": "817-842-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 E 210th St",
            "address_2": "Montefiore Medical Center",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ-DIAZ",
        "first_name": "JANICE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32889",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.