Individual ProviderCarlos HernandezDentistDental ProvidersPractice AddressClemente Orozco #1506-203, Zona Urbana Rio, Tijuana, Baja California 22010 (Mexico)(619) 600-5265PECOS EnrollmentBased on the most recent information from CMS, provider Carlos Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1437716453Provider TypeIndividualFull NameHernandez, CarlosTitleDr.CredentialD.D.S.GenderMaleSole ProprietorYesEnumeration Date5/24/2019Last Updated5/24/2019Contact InformationPractice LocationPractice AddressClemente Orozco #1506-203, Zona Urbana Rio, Tijuana, Baja California 22010 (Mexico)Phone(619) 600-5265Fax(858) 430-3143Mailing LocationMailing Address4492 Camino De La Plaza #1441, San Ysidro, CA 92173-3129Phone(619) 600-5265Fax(858) 430-3143Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense2894286