Active NPI
Marcelo Manuel Lopez Hernandez, D.D.S.
- Dentist
- Tijuana, CA
National Provider Identifier
1134593288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 871239
- Practice address
- Blvd. Bellas Artes #341-1
Colonia Nueva Tijuana
Tijuana, CA 22435 - Phone
- (011) 526-6462
- NPI assigned
- Nov 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 871239 | ZZ | Primary |
Addresses
Primary practice location
Blvd. Bellas Artes #341-1
Colonia Nueva Tijuana
Tijuana, CA 22435
Mailing address
4364 Bonita Rd. #233
Bonita, CA 91902-1421
Phone (011) 526-6462
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 871239 | ZZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448841600000",
"number": "1134593288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4364 BONITA RD. #233",
"city": "BONITA",
"state": "CA",
"postal_code": "919021421",
"telephone_number": "011-526-6462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLVD. BELLAS ARTES #341-1",
"address_2": "COLONIA NUEVA TIJUANA",
"city": "TIJUANA",
"state": "CA",
"postal_code": "22435",
"telephone_number": "011-526-6462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ HERNANDEZ",
"first_name": "MARCELO",
"middle_name": "MANUEL",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-30",
"last_updated": "2015-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ZZ",
"license": "871239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tijuana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.