Individual provider Active NPI

Maria Esther Lopez

  • Dentist
  • Pembroke Pines, FL
National Provider Identifier
1538550462
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21166 Issued in FL
Practice address
11401 Pines Blvd Ste 220
Pembroke Pines, FL 33026-4104
Phone
(954) 432-5515
NPI assigned
Feb 13, 2015
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21166 FL Primary

Addresses

Primary practice location

11401 Pines Blvd Ste 220
Pembroke Pines, FL 33026-4104

Mailing address

14411 NW 83Rd Ave
Miami Lakes, FL 33016-5714
Phone (305) 431-2441

Other identifiers 1

IdentifierTypeStateIssuer
016679500MedicaidFL

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
DN21166FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1538550462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 NW 83RD AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165714",
            "telephone_number": "305-431-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 PINES BLVD STE 220",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264104",
            "telephone_number": "954-432-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARIA",
        "middle_name": "ESTHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016679500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.