Manuel Lopez, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7303 Issued in NC

Practice address

280 Concord Pkwy S Ste 110a
Concord, NC 28027-2704

Phone

(704) 920-1070

Fax

(704) 920-1071

NPI assigned

Mar 6, 2007

Last updated

Apr 26, 2012By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1326178518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CONCORD PKWY S STE 110A",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272704",
            "telephone_number": "704-920-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 CONCORD PKWY S STE 110A",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272704",
            "telephone_number": "704-920-1070",
            "fax_number": "704-920-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90177",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990177",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank E Long, MD
• Jonathan Braxton Long, LCSW-A
• Nicole Lopes
• Gabrielle Alexandria Lopez, LCSWA
• Katelyn Lopez
• Doua Chee Lor, OD
• Mai S Lor
• Kelly O'Neill Lord, MA, NCC, LCMHC
• Morgan Lotfy, OTR/L
• James Leslie Louden III

• General Practice Dentistry in Concord, NC
• Providers in Concord, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.