Healthcare Provider Details

I. General information

NPI: 1679482335
Provider Name (Legal Business Name): ANA LILIAN LOPEZ, DMD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8255 LEE VISTA BLVD STE D
ORLANDO FL
32829-8018
US

IV. Provider business mailing address

8255 LEE VISTA BLVD STE D
ORLANDO FL
32829-8018
US

V. Phone/Fax

Practice location:
  • Phone: 904-256-7846
  • Fax:
Mailing address:
  • Phone: 407-447-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ANA LILIAN LOPEZ
Title or Position: ORTHONTIST/OWNER
Credential: DMD
Phone: 407-910-5211