MEDICARE: DR. CARLOS A LOPEZ D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1895	PR
2	261QD0000X	Dental Clinic/Center	1895	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N689	OTHER	PR	DENTIST
2	7290033	OTHER	PR	DENTIST
3	041451	OTHER	PR	DENTIST
4	206104	OTHER	PR	DENTIST
5	41707	OTHER	PR	DENTIST

General Provider Information

NPI Number	:	1245365295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS A LOPEZ D.M.D

Provider Business Mailing Address
First Line	:	215 CALLE TOUS SOTO
Second Line	:	URB BALDRICH
City	:	SAN JUAN
State	:	PR
Zip	:	00918-4312
Country	:	US
Telephone Number	:	787-444-7910
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 CALLE TOUS SOTO
Second Line	:	URB. BALDRICH
City	:	SAN JUAN
State	:	PR
Zip	:	00918-4312
Country	:	US
Telephone Number	:	787-444-7910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/11/2025

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Directions to “ DR. CARLOS A LOPEZ D.M.D” Practice Location

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