Active NPI
Ricardo Javier Hernandez, DDS
- General Practice Dentistry
- San Diego, CA
National Provider Identifier
1972746063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40245
- Practice address
- 4460 Olney St
San Diego, CA 92109-4742 - Phone
- (858) 272-6047
- Fax
- (858) 272-4332
- NPI assigned
- Apr 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40245 | CA | Primary |
Addresses
Primary practice location
4460 Olney St
San Diego, CA 92109-4742
Mailing address
4460 Olney St.
San Diego, CA 92109
Phone (858) 272-6047
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40245 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240185600000",
"number": "1972746063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4460 OLNEY ST.",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92109",
"telephone_number": "858-272-6047",
"fax_number": "858-272-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4460 OLNEY ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921094742",
"telephone_number": "858-272-6047",
"fax_number": "858-272-4332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "RICARDO",
"middle_name": "JAVIER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-20",
"last_updated": "2009-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "40245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.