Individual provider Active NPI

Jose Luis Hernandez, DMD

  • General Practice Dentistry
  • Carolina, PR
National Provider Identifier
1669479028
Registry record updated Jul 13, 2026
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1294 Issued in PR
Practice address
Marginal Villamar
#35
Carolina, PR 00979
Phone
(787) 726-0503
Fax
(787) 727-5916
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1294 PR Primary

Addresses

Primary practice location

Marginal Villamar
#35
Carolina, PR 00979

Mailing address

Marginal Villamar
#35
Carolina, PR 00979
Phone (787) 726-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023001360 PR Order and Referring Only - DentistPractitioner - Dentist 9032428537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1294PRMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669479028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARGINAL VILLAMAR",
            "address_2": "#35",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-726-0503",
            "fax_number": "787-727-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARGINAL VILLAMAR",
            "address_2": "#35",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-726-0503",
            "fax_number": "787-727-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.