Provider Demographics
NPI:1558431627
Name:HERNANE, JANE D (DDS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:D
Last Name:HERNANE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:D
Other - Last Name:HERNANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:GENERAL DENTISTRY
Mailing Address - Street 1:948 MONTAGUE CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-8810
Mailing Address - Country:US
Mailing Address - Phone:951-733-5573
Mailing Address - Fax:951-736-6102
Practice Address - Street 1:247 W CARSON ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2604
Practice Address - Country:US
Practice Address - Phone:310-847-7077
Practice Address - Fax:310-847-7078
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice