MEDICARE: KARINA VERA-LOPEZ DDS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401413216	VA

General Provider Information

NPI Number	:	1275926065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARINA VERA-LOPEZ DDS PLLC

Provider Business Mailing Address
First Line	:	4321 RIDGEWOOD CENTER DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-5308
Country	:	US
Telephone Number	:	703-590-4666
Fax Number	:	703-897-1526

Provider Business Practice Location Address
First Line	:	4321 RIDGEWOOD CENTER DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-5308
Country	:	US
Telephone Number	:	703-590-4666
Fax Number	:	703-897-1526

Authorized Official
Title or Position	:	OWNER
Name	:	KARINA VERA-LOPEZ DDS
Credential	:
Telephone Number	:	703-626-9487

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	07/16/2025

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