Individual provider Active NPI

Laura Lopez Jauregui, DMD

  • General Practice Dentistry
  • Kingsburg, CA
National Provider Identifier
1043827801
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105542 Issued in CA
Practice address
1064 Lewis St
Kingsburg, CA 93631-2414
Phone
(559) 897-2600
NPI assigned
Sep 25, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 105542 CA Primary

Addresses

Primary practice location

1064 Lewis St
Kingsburg, CA 93631-2414

Mailing address

1468 N Poplar Ave
Fresno, CA 93728-1932
Phone (505) 469-5466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207003011 NM Order and Referring Only - DentistPractitioner - Dentist 3375986250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105542CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Surdeep Dental Group of Fresno Inc General Practice CurrentSince Jun 23, 2025 Accepting new patients
Kingsburg Family Dental General Practice PastSince Sep 27, 2020 Accepting new patients

Locations

1064 Lewis St
Kingsburg, CA 93631
Phone (559) 897-2600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEGHBA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1043827801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 N POPLAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937281932",
            "telephone_number": "505-469-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 LEWIS ST",
            "city": "KINGSBURG",
            "state": "CA",
            "postal_code": "936312414",
            "telephone_number": "559-897-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ JAUREGUI",
        "first_name": "LAURA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsburg, CA

Sources for this page

Verify at the official NPI Registry.