Provider Demographics
NPI:1326591389
Name:HERNANDEZ INFANTE, ILIANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ILIANA
Middle Name:
Last Name:HERNANDEZ INFANTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5452 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1618
Mailing Address - Country:US
Mailing Address - Phone:661-322-2300
Mailing Address - Fax:661-845-3739
Practice Address - Street 1:5452 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1618
Practice Address - Country:US
Practice Address - Phone:661-322-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist