Individual provider Active NPI

Diego Alfonso Lopez, DMD

  • Dentist
  • San Antonio, TX
National Provider Identifier
1396475505
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38653 Issued in TX
Practice address
11831 Culebra Rd Ste 101
San Antonio, TX 78253-4578
Phone
(210) 625-5353
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38653 TX Primary

Addresses

Primary practice location

11831 Culebra Rd Ste 101
San Antonio, TX 78253-4578

Mailing address

4065 Chaucer LN
Farmers Branch, TX 75244-8107
Phone (210) 630-7160

Other practice location 1

4518 Rowlett Rd
Rowlett, TX 75088-5081
Phone (469) 299-8462

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

LicenseStateTypeSpecialty
38653TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Purple Iris Dental Association PastSince Dec 28, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1396475505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4065 CHAUCER LN",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752448107",
            "telephone_number": "210-630-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11831 CULEBRA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534578",
            "telephone_number": "210-625-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4518 Rowlett Rd",
            "address_purpose": "LOCATION",
            "city": "Rowlett",
            "state": "TX",
            "postal_code": "750885081",
            "country_code": "US",
            "telephone_number": "469-299-8462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "DIEGO",
        "middle_name": "ALFONSO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.