Active NPI
Nancy Lopez, B.S.
- Dental Assistant
- Moreno Valley, CA
National Provider Identifier
1104264399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 67522
- Practice address
- 16164 Ebony Ave
Moreno Valley, CA 92551-9228 - Phone
- (951) 236-0260
- NPI assigned
- Jun 10, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 67522 | CA | Primary |
| Dental Hygienist | 124Q00000X | 27777 | CA |
Addresses
Primary practice location
16164 Ebony Ave
Moreno Valley, CA 92551-9228
Mailing address
16164 Ebony Ave
Moreno Valley, CA 92551-9228
Phone (951) 236-0260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27777 | CA | MD | Dental Hygienist |
| 67522 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377475200000",
"number": "1104264399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16164 EBONY AVE",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925519228",
"telephone_number": "951-236-0260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16164 EBONY AVE",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925519228",
"telephone_number": "951-236-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "NANCY",
"credential": "B.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-10",
"last_updated": "2013-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "67522",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "27777",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.