Marco Lopez, RDH

Individual provider Active NPI Dental Hygienist · Colusa, CA

NPI 1487582854 · NPPES record last updated May 13, 2026

Key facts

NPI
1487582854
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
36358 (CA)
Practice address
360 5TH St
Colusa, CA 95932-2467
Phone
(530) 458-3614
NPI assigned
May 13, 2026
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
36358CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colusa Indian Community Council Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 36358 CA Yes

Addresses

Primary practice location

360 5TH St
Colusa, CA 95932-2467

Mailing address

360 5TH St
Colusa, CA 95932-2467
Phone (530) 458-3614

Other providers in Colusa, CA

All providers in Colusa, CA · Dental Hygienist in California

Sources for this page

Verify at the official NPI Registry.