Marco Lopez

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401415354 Issued in VA

Practice address

500 Gypsy LN FL 3
Youngstown, OH 44504-1315

Phone

(330) 884-3058

NPI assigned

Jun 12, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ankle and Foot Care Centers

  • Foot & Ankle Surgery Podiatrist
  • Ravenna, OH
  • NPI 1154707818
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475280000000",
    "number": "1033523642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN FL 3",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "330-884-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN FL 3",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "330-884-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARCO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2016-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "3423",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Marie Long, CDCA
• Michell Lyn Long, LSW
• Taylor Marie Long
• Heather Loper
• Joel Lopez
• Michael Lopez
• Bret Michael Lorenzo, DPT
• Jazzminne L Lott
• Pamela Lott
• Sarah Loughner, SLP

• General Practice Dentistry in Youngstown, OH
• Providers in Youngstown, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.