Active NPI
Jorge L Hernandez, D.M.D
- Prosthodontics
- Pearland, TX
National Provider Identifier
1558568402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 30547
- Practice address
- 11901 Shadow Creek Pkwy Ste 135
Pearland, TX 77584-7346 - Phone
- (281) 206-2211
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 2768 | PR | |
| Prosthodontics | 1223P0700X | 30547 | TX | Primary |
Addresses
Primary practice location
11901 Shadow Creek Pkwy Ste 135
Pearland, TX 77584-7346
Mailing address
1706 Yellow Iris TRL
Richmond, TX 77406-5010
Phone (787) 948-8489
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30547 | TX | MD | Prosthodontist |
| 2768 | PR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1558568402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 YELLOW IRIS TRL",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774065010",
"telephone_number": "787-948-8489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11901 SHADOW CREEK PKWY STE 135",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775847346",
"telephone_number": "281-206-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "JORGE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "PR",
"license": "2768",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TX",
"license": "30547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.