Healthcare Provider Details

I. General information

NPI: 1457279242
Provider Name (Legal Business Name): JNM DENTAL PARTNERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 W CENTRAL AVE STE 103
SANTA ANA CA
92707-3100
US

IV. Provider business mailing address

1155 W CENTRAL AVE STE 103
SANTA ANA CA
92707-3100
US

V. Phone/Fax

Practice location:
  • Phone: 949-795-8115
  • Fax: 949-392-6401
Mailing address:
  • Phone: 949-795-8115
  • Fax: 949-392-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NOEL HERNANDEZ
Title or Position: VICE PRESIDENT
Credential: RDAEF2
Phone: 949-795-8115