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NPI Code Detail

MEDICARE: DR. ANA MELISSA LOPEZ DMD

MEDICARE: DR. ANA MELISSA LOPEZ DMD
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
1122300000XDentist019-025964IL
21223P0221XPediatric Dentistry021-002145IL
31223P0221XPediatric Dentistry61988CA

General Provider Information

NPI Number : 1740390285
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANA MELISSA LOPEZ DMD
Provider Business Mailing Address
First Line : 520 LENNON LN STE A
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2415
Country : US
Telephone Number : 925-930-9390
Fax Number :
Provider Business Practice Location Address
First Line : 520 LENNON LN STE A
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2415
Country : US
Telephone Number : 925-930-9390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/13/2021

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