Provider Demographics
NPI:1588292908
Name:HINOJOSA, JOSE (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 AQUIDNECK ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744-2005
Mailing Address - Country:US
Mailing Address - Phone:347-748-4100
Mailing Address - Fax:
Practice Address - Street 1:387 QUARRY ST STE 100
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1026
Practice Address - Country:US
Practice Address - Phone:347-748-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1864784591223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY366523339OtherID