Provider Demographics
NPI:1407136278
Name:HERNANDEZ, SCARLETT R (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCARLETT
Middle Name:R
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SCARLETT
Other - Middle Name:R
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1 BANK ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1504
Mailing Address - Country:US
Mailing Address - Phone:240-393-7823
Mailing Address - Fax:
Practice Address - Street 1:1 BANK ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1504
Practice Address - Country:US
Practice Address - Phone:240-393-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist