Individual provider Active NPI

Gerald Lopez, D.D.S.

  • General Practice Dentistry
  • Rancho Cucamonga, CA
National Provider Identifier
1225134216
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57332 Issued in CA
Practice address
13089 Falling Oak Dr
Rancho Cucamonga, CA 91739-5929
Phone
(909) 803-0440
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 57332 CA Primary

Addresses

Primary practice location

13089 Falling Oak Dr
Rancho Cucamonga, CA 91739-5929

Mailing address

13089 Falling Oak Dr
Rancho Cucamonga, CA 91739-5929
Phone (909) 803-0440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150902001486 CA Order and Referring Only - DentistPractitioner - Dentist 8527374784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1225134216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13089 FALLING OAK DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917395929",
            "telephone_number": "909-803-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13089 FALLING OAK DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917395929",
            "telephone_number": "909-803-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GERALD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.