Healthcare Provider Details

I. General information

NPI: 1437079498
Provider Name (Legal Business Name): MARIA LUIZA LOPES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 WAVERLEY ST
FRAMINGHAM MA
01702-7059
US

IV. Provider business mailing address

23 PEARL LAKE RD APT K
WATERBURY CT
06706-2500
US

V. Phone/Fax

Practice location:
  • Phone: 800-853-2288
  • Fax:
Mailing address:
  • Phone: 230-818-8332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: