=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467328815
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIC HERNANDEZ DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2025
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32ND ST., ST. LUKES MEDICAL CENTER GLOBAL CITY
-----------------------------------------------------
City | TAGUIG CITY
-----------------------------------------------------
State | METRO MANILA
-----------------------------------------------------
Zip | 01604
-----------------------------------------------------
Country | PH
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1961 KASOY ST. BARANGAY DASMARINAS
-----------------------------------------------------
City | MAKATI CITY
-----------------------------------------------------
State | METRO MANILA
-----------------------------------------------------
Zip | 01222
-----------------------------------------------------
Country | PH
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | DDS46823
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------