NPIMap

Organization Active NPI

Sergio M. Lopez, D.D.S.,P. L.L.C.

  • Dental Clinic/Center
  • Tampa, FL
National Provider Identifier
1083931729
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
18229 Issued in FL
Legal business name
SERGIO M. LOPEZ, D.D.S.,P. L.L.C.
Practice address
3102 W Waters Ave
Suite 101
Tampa, FL 33614-2882
Phone
(813) 374-2441
Fax
(813) 513-2925
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Authorized official

Name
Dr. Sergio M. Lopez, D.D.S.NPI 1265441125
Title
Dentist
Phone
(303) 513-5041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 18229 FL Primary

Addresses

Primary practice location

3102 W Waters Ave
Suite 101
Tampa, FL 33614-2882

Mailing address

3102 W Waters Ave
Suite 101
Tampa, FL 33614-2882
Phone (813) 374-2441

Other identifiers 3

IdentifierTypeStateIssuer
013389200MedicaidFL
44821026MedicaidCO
007861100MedicaidFL

National Provider Directory

National Provider Directory

Locations

3102 W Waters Ave
Ste 101
Tampa, FL 33614
Phone (813) 374-2441

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1083931729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 W WATERS AVE",
            "address_2": "SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142882",
            "telephone_number": "813-374-2441",
            "fax_number": "813-513-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 W WATERS AVE",
            "address_2": "SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142882",
            "telephone_number": "813-374-2441",
            "fax_number": "813-513-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO M. LOPEZ, D.D.S.,P. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "303-513-5041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "18229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013389200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44821026",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007861100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.