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General NPI Number Information
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NPI Number | 1932835436
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Entity Type | Individual
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Provider Name | ALEXANDER NICHOLAS LOPEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 6050 BRYNWOOD DR
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City | ROCKFORD
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State | IL
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Zip | 61114-6579
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Country | US
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Telephone | 815-201-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 E CAMPUS LOOP S
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City | LINCOLN
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State | NE
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Zip | 68583-1530
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Country | US
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Telephone |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 021003428
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License Number State | IL
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