Healthcare Provider Details

I. General information

NPI: 1962613406
Provider Name (Legal Business Name): LANE J LOPEZ DDS & HOOMAN M ZARRINKELK DDS APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2859 LOMA VISTA ROAD SUITE A
VENTURA CA
93003
US

IV. Provider business mailing address

2859 LOMA VISTA ROAD SUITE A
VENTURA CA
93003
US

V. Phone/Fax

Practice location:
  • Phone: 805-648-5121
  • Fax: 805-648-3670
Mailing address:
  • Phone: 805-648-5121
  • Fax: 805-648-3670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateCA

VIII. Authorized Official

Name: LANE J LOPEZ
Title or Position: PRESIDENT
Credential: DDS
Phone: 805-648-5121