Provider Demographics
NPI:1851851968
Name:HERNANDEZ, LIANET (DDS)
Entity Type:Individual
Prefix:
First Name:LIANET
Middle Name:
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 1:4431 SW 102ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5022
Mailing Address - Country:US
Mailing Address - Phone:786-322-9770
Mailing Address - Fax:
Practice Address - Street 1:8290 BIRD RD STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3351
Practice Address - Country:US
Practice Address - Phone:305-456-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL262781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice