Provider Demographics
NPI:1740439264
Name:ARTURO V. HERNANDEZ, D.D.S.
Entity type:Organization
Organization Name:ARTURO V. HERNANDEZ, D.D.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:VILLARAZA
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-351-7661
Mailing Address - Street 1:3120 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1702
Mailing Address - Country:US
Mailing Address - Phone:323-469-5700
Mailing Address - Fax:323-469-5703
Practice Address - Street 1:875 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-3759
Practice Address - Country:US
Practice Address - Phone:323-469-5700
Practice Address - Fax:323-469-5703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARTURO V. HERNANDEZ, D.D.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-09
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31925305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA026360OtherDELTA CARE