Provider Demographics
NPI:1851381073
Name:HERNANDEZ, MILADYS A I (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILADYS
Middle Name:A
Last Name:HERNANDEZ
Suffix:I
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:MILADYS
Other - Middle Name:A
Other - Last Name:HERNANDEZ
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8723 112TH ST
Mailing Address - Street 2:RICHMOND HILL
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2318
Mailing Address - Country:US
Mailing Address - Phone:718-846-8076
Mailing Address - Fax:718-847-9464
Practice Address - Street 1:113 10 JAMAICA AVE
Practice Address - Street 2:JAMAICA
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2440
Practice Address - Country:US
Practice Address - Phone:718-847-8807
Practice Address - Fax:718-847-9464
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0449861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01439427Medicaid