Juan Carlos Hernandez, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN013633 Issued in GA

Practice address

3705 Old Norcross Rd Ste 300
Duluth, GA 30096-4336

Phone

(770) 813-0777

Fax

(770) 813-1023

NPI assigned

Nov 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Juan Carlos Hernandez Huertas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Balance Advanced Dentistry & Orthodontics Gwinnett LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Duluth, GA
  • NPI 1972200509
  NPD (past) Authorized official

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1669652152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 OLD NORCROSS RD STE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964336",
            "telephone_number": "347-228-4321",
            "fax_number": "770-813-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 OLD NORCROSS RD STE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964336",
            "telephone_number": "770-813-0777",
            "fax_number": "770-813-1023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 W 6th St",
            "address_2": "Suite 19 Bldg 440 US Army Dental Activity",
            "address_purpose": "LOCATION",
            "city": "Ft Stewart",
            "state": "GA",
            "postal_code": "313144707",
            "country_code": "US",
            "telephone_number": "912-767-6735",
            "fax_number": "912-767-5425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2381 Main St E",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300783358",
            "country_code": "US",
            "telephone_number": "770-813-0777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1670 McKendree Church Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300434100",
            "country_code": "US",
            "telephone_number": "770-813-0777",
            "fax_number": "678-615-7103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013633",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013633",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN013633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669652152",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "HERNANDEZ HUERTAS",
            "middle_name": "CARLOS",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shelby Lynn Henry, RBT
• Kayleigh Her, RBT
• Herman Medical Solutions, LLC
• Jennifer Hernandez, CNA
• Jennifer Hernandez, BCBA
• Hernest Maternal Health, LLC
• Kathryn Rebecca Herrera, PA- C
• Mercedita Herrera, MSPH
• Joshua Herron, DC
• Kimberly Belle Hewitt, OTR

• Orthodontics and Dentofacial Orthopedics Dentistry in Duluth, GA
• Providers in Duluth, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.