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General NPI Number Information
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NPI Number | 1609762400
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Entity Type | Individual
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Provider Name | JENNIFER HERNANDEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1775 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10453-8202
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Country | US
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Telephone | 718-901-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 6601 BROADWAY APT 7C
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City | BRONX
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State | NY
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Zip | 10471-2073
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Country | US
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Telephone | 347-702-0077
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1223G0001X
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License Number State | NY
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