Vivian Fernande Lopez, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

29355 Issued in CA

Practice address

2821 Telegraph Ave
Berkeley, CA 94705-1118

Phone

(510) 848-4430

Fax

(510) 845-3834

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104957075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051118",
            "telephone_number": "510-848-4430",
            "fax_number": "510-845-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051118",
            "telephone_number": "510-848-4430",
            "fax_number": "510-845-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "VIVIAN",
        "middle_name": "FERNANDE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "29355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B29355",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Kay Lopez, LCSW
• Antoinette Lopez, MD
• Jesse Lopez
• Michael Edward Lopez, PT, DPT
• Victoria Lopez, RN, PHN, MPH
• Janet Phyllis Lord, MD
• Stuart Lord, LMFT
• Deeahna Marie Lorenz, PH.D.
• Especianise Loresca, M.D.
• Lori Shore MD, Inc

• Pediatric Dentistry in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.