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General NPI Number Information
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NPI Number | 1285856906
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Entity Type | Individual
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Provider Name | JUAN R HERNANDEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 18160 HWY 281 NORTH SUITE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78232
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Country | US
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Telephone | 210-495-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 29054 AXIS VW
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City | BOERNE
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State | TX
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Zip | 78006-9447
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Country | US
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Telephone | 210-975-8825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 052651
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31785
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License Number State | TX
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