Juan Diego Hernandez, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1477 Issued in PR

Practice address

Extencion Betances #181
Road 155 KM.66.8
Vega Baja, PR 00693

Phone

(787) 858-2744

Fax

(787) 858-2744

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1851396584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006920390",
            "telephone_number": "787-858-2744",
            "fax_number": "787-858-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EXTENCION BETANCES #181",
            "address_2": "ROAD 155 KM.66.8",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-858-2744",
            "fax_number": "787-858-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "DIEGO",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guzman Medical Center CSP
• Elizabeth Guzman, MD
• Lillian Hernandez Cortes, DMD
• Hernandez Enterprise Corp
• Angel Ivan Hernandez, DDS
• Julianys Hernandez
• His Pharmacy LLC
• Hospicio Divino Salvador, Inc.
• Innovative Hospitalist Medicine Care, Inc.
• Innovative Imaging Solutions LLC

• General Practice Dentistry in Vega Baja, PR
• Providers in Vega Baja, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.