Provider Demographics
NPI:1053142653
Name:HERNANDEZ PEREZ, BARBARA (DDS)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:HERNANDEZ PEREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 CREEKSIDE TERRACE WAY APT 6005
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2892
Mailing Address - Country:US
Mailing Address - Phone:865-333-2328
Mailing Address - Fax:
Practice Address - Street 1:875 HIGHWAY 321 N STE 200
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-7397
Practice Address - Country:US
Practice Address - Phone:865-816-6327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN126281223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice