Gustavo Hernan Lopez Gomez

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

062406-01 Issued in NY

Practice address

111 Broadway RM 1304
New York, NY 10006-1999

Phone

(212) 600-1996

NPI assigned

Oct 28, 2020

Sex

Male

Sole proprietor

No

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

Practice roles

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

• Sky Dental, P.C.

  • General Practice Dentistry
  • New York, NY
  • NPI 1154946689
  NPD (past)

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1184224230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 HIGH ST APT 309",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062360",
            "telephone_number": "813-447-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BROADWAY RM 1304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061999",
            "telephone_number": "212-600-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ GOMEZ",
        "first_name": "GUSTAVO",
        "middle_name": "HERNAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NY",
            "license": "062406-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "062406-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannie Lope, FNP, RN
• Sally Loper, LCSW
• Arquelina Benros Lopes, MA
• Christina Lopes, DPT
• Jorge Luis Lopez Cuello, MD
• Analis Lopez Gonzales, LMSW
• Alonso Fernando Lopez Herrera, MD
• Persio David Lopez Loyo, MD
• David Alejandro Lopez Molina, M.PHIL
• Lopez Physical Medicine Consultancy, PLLC

• Public Health Dentistry in New York, NY
• Providers in New York, NY by specialty
• Public Health Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.