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General NPI Number Information
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NPI Number | 1740390285
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Entity Type | Individual
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Provider Name | ANA MELISSA LOPEZ DMD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 520 LENNON LN STE A
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2415
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Country | US
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Telephone | 925-930-9390
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Fax |
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Provider Business Mailing Address
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Address Line | 520 LENNON LN STE A
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2415
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Country | US
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Telephone | 925-930-9390
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019-025964
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 021-002145
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 61988
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License Number State | CA
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