Individual provider Active NPI

Javier H. Lopez, DDS

  • General Practice Dentistry
  • Antioch, CA
National Provider Identifier
1609278076
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63950 Issued in CA
Practice address
800 C St
Antioch, CA 94509-1719
Phone
(925) 757-4700
Fax
(925) 756-7975
NPI assigned
Sep 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 63950 CA Primary

Addresses

Primary practice location

800 C St
Antioch, CA 94509-1719

Mailing address

800 C St
Antioch, CA 94509-1719
Phone (925) 757-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210528000394 CA Practitioner - Oral SurgeryPractitioner - Dentist 6507100682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4021CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Javier H. Lopez DDS, Inc Dentist Current Accepting new patients
Maria T Alarcon DDS Dental Corporation Dentist CurrentSince Feb 13, 2021 Accepting new patients

Locations

800 C St
Antioch, CA 94509
Phone (925) 757-4700

19682 Hesperian Blvd
Ste 208
Hayward Acres, CA 94541
Phone (510) 253-2350

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1609278076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 C ST",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945091719",
            "telephone_number": "925-757-4700",
            "fax_number": "925-756-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 C ST",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945091719",
            "telephone_number": "925-757-4700",
            "fax_number": "925-756-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JAVIER",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2023-03-17",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.