Eduardo Domingo Lopez, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401417237 Issued in VA

Practice address

4326 George Washington Mem Hwy
Yorktown, VA 23692-2707

Phone

(757) 969-1356

NPI assigned

May 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1215501440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4326 GEORGE WASHINGTON MEM HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236922707",
            "telephone_number": "757-969-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4326 GEORGE WASHINGTON MEM HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236922707",
            "telephone_number": "757-969-1356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Bulifants Blvd",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231885722",
            "country_code": "US",
            "telephone_number": "757-220-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "EDUARDO",
        "middle_name": "DOMINGO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417237",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Mariah Livingston, LPTA
• Jesus L. Lizarzaburu, M.D.
• Lloyd Cloud Therapy Services, LLC
• Amanda Sue Lois, PA-C
• James Chrisman Loomis, M.A., L.P.C.
• Michele R Lorraine
• Morgan Maharty, OD
• Cheryl Ann Mansfield, LCSW, CSAC
• Lawrence Steven Marchelya, D.D.S.
• Asya Gyurjyan Marsh

• Dentist in Yorktown, VA
• Providers in Yorktown, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.