Nicole Hernandez, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN24840 Issued in FL

Practice address

2711 Tampa Rd
Palm Harbor, FL 34684-3336

Phone

(727) 786-1631

NPI assigned

Mar 14, 2012

Last updated

Aug 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pearl Solutions LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Tampa, FL
  • NPI 1568117091
  Authorized official Same address or phone
• Michael a. Pikos, DDS PA

  dba Coastal Jaw Surgery - Tampa

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Tampa, FL
  • NPI 1730747395
  NPD (past)

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1790050474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W GRAND CENTRAL AVE UNIT 814",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061978",
            "telephone_number": "813-751-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 TAMPA RD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843336",
            "telephone_number": "727-786-1631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 Lexington Ave",
            "address_2": "Apt 3B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100160989",
            "country_code": "US",
            "telephone_number": "813-751-5958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "NICOLE",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN24840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Hengstebeck, HIS
• Yasna Jasmine Heravi-Burgos, PSY.D.
• Janice M Herbert, M.D.
• Halina Herman, PHD
• Nathan Hernandez, PTA
• Richard W Hernandez, O.D.
• Irina Alejandra Herrera, PMHNP
• Susan Hessner, ARNP
• Faith Heyns
• Carla F Hickey, AU.D.

• Oral and Maxillofacial Surgery (Dentist) in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.