Individual provider Active NPI

Florencia Hernandez, DDS

  • General Practice Dentistry
  • Prescott Valley, AZ
National Provider Identifier
1871803825
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8095 Issued in AZ
Practice address
8256 E State Route 69
Prescott Valley, AZ 86314-8403
Phone
(928) 772-4433
Fax
(928) 772-5582
NPI assigned
Oct 8, 2010
Last updated
Oct 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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 D8095 AZ Primary

Addresses

Primary practice location

8256 E State Route 69
Prescott Valley, AZ 86314-8403

Mailing address

2629 W Orangewood Ave
Phoenix, AZ 85051-6874
Phone (602) 864-5558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170628001195 AZ Practitioner - Oral Surgery 1850699844
I20220706001560 TX Practitioner - Dentist 1850699844 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D8095AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince May 1, 2017 Accepting new patients
Tuba City Regional Health Care Corporation General Practice CurrentSince Jun 21, 2022 Accepting new patients
North Country Healthcare, Inc. CurrentSince May 1, 2017 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jun 21, 2022 Accepting new patients

Locations

1501 S Yale St
Ste 252
Flagstaff, AZ 86001
Phone (928) 774-1811

2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100

300 S 6th St
Williams, AZ 86046
Phone (928) 635-4441

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1871803825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 W ORANGEWOOD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516874",
            "telephone_number": "602-864-5558",
            "fax_number": "602-864-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8256 E STATE ROUTE 69",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148403",
            "telephone_number": "928-772-4433",
            "fax_number": "928-772-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "FLORENCIA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D8095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.