Active NPI
Diego Alfonso Lopez, DMD
- Dentist
- San Antonio, TX
National Provider Identifier
1396475505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 38653
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 38653 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Purple Iris Dental Association | Past | 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.
-
- Pediatric Dentistry
- San Antonio, TX
- NPI 1558849893
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.