MEDICARE: CHRISTOPHER RALF TAINA LOPEZ DDS

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	122300000X	Dentist	016.0123604	VT
2	122300000X	Dentist	DDS-09346	IA
3	122300000X	Dentist	DDS108323	CA

General Provider Information

NPI Number	:	1649725268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER RALF TAINA LOPEZ DDS

Provider Business Mailing Address
First Line	:	120 LAMMERHAVEN CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95111-3715
Country	:	US
Telephone Number	:	408-807-5712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1639 HOLLENBECK AVE
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-5402
Country	:	US
Telephone Number	:	408-359-5144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	01/12/2026

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