Carlos Alfonso Lopez Diaz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

101712 Issued in CA

Practice address

31843 Rancho California Rd Ste 300
Temecula, CA 92591-5120

Phone

(951) 676-2613

NPI assigned

Aug 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Chu and Watanabe Dental Corporation

  • General Practice Dentistry
  • Temecula, CA
  • NPI 1205990496
  NPD (past)

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1467978262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30985 SAMANTHA LN",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925922992",
            "telephone_number": "951-404-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31843 RANCHO CALIFORNIA RD STE 300",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915120",
            "telephone_number": "951-676-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ DIAZ",
        "first_name": "CARLOS",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS101712",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Elaine Longoria
• Longs Drug Stores California LLC
• Longs Drug Stores California LLC
• Longs Drug Stores California LLC
• Cinthia Lopez Bueno
• Danielle M Lopez-Bopp, MFT
• Erika Lopez-Garcia
• Cynthia Lopez-Leon
• Alicia Lopez-Zepeda
• Alondra Natalie Lopez

• Dentist in Temecula, CA
• Providers in Temecula, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.