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General NPI Number Information
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NPI Number | 1740971381
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Entity Type | Individual
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Provider Name | DYLAN FERNANDEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 26137 LA PAZ RD STE 270
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5333
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Country | US
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Telephone | 949-581-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 21451 BIRDHOLLOW DR
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City | TRABUCO CANYON
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State | CA
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Zip | 92679-3359
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Country | US
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Telephone | 949-302-3726
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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 | 109123
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License Number State | CA
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