Provider Demographics
NPI:1629290846
Name:HERNANDEZ, SILVIA C (DDS)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:C
Last Name:HERNANDEZ
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 1:20640 AVENUE 164
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-9288
Mailing Address - Country:US
Mailing Address - Phone:559-783-9098
Mailing Address - Fax:
Practice Address - Street 1:784 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-1941
Practice Address - Country:US
Practice Address - Phone:559-783-9154
Practice Address - Fax:559-783-9190
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA723480OtherUNITED CONCORDIA
CAB42283-02OtherHEALTHY FAMILIES
CAG93690-01OtherDENTI-CAL #
CA2-42283OtherDELTA DENTAL OF CALIFORNI
CA42283OtherDELTADENTAL AND ALL OTHER
CA75003OtherTULARE HEALTHY FAMILIES