Individual provider Active NPI

Ximena Hernandez, D.D.S

  • Dentist
  • Englewood, NJ
National Provider Identifier
1801089867
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI-01854100 Issued in NJ
Practice address
40 W Palisade Ave
Suite 202
Englewood, NJ 07631-2746
Phone
(201) 266-0854
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI-01854100 NJ Primary

Addresses

Primary practice location

40 W Palisade Ave
Suite 202
Englewood, NJ 07631-2746

Mailing address

40 W Palisade Ave
Suite 202
Englewood, NJ 07631-2746
Phone (201) 266-0854

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI-01854100NJMDDentist
044532NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1801089867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W PALISADE AVE",
            "address_2": "SUITE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312746",
            "telephone_number": "201-266-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W PALISADE AVE",
            "address_2": "SUITE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312746",
            "telephone_number": "201-266-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "XIMENA",
        "name_prefix": "Mrs.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI-01854100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.