Individual provider Active NPI

Michael Lopez, DDS

  • General Practice Dentistry
  • Livermore, CA
National Provider Identifier
1679559348
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD57591 Issued in CA
Practice address
4375 1St St
Livermore, CA 94551-4912
Phone
(650) 580-1082
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 DD57591 CA Primary

Addresses

Primary practice location

4375 1St St
Livermore, CA 94551-4912

Mailing address

PO Box 370
Hatch, NM 87937-0370
Phone (505) 267-3088

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
I20150806011162 CA Order and Referring Only - DentistPractitioner - Dentist 8022322858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD2683NMMDGeneral Practice Dentistry
57591CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lopez and Lambridis Dental Corporation PastSince Mar 22, 2020 Accepting new patients
Ben Archer Health Center Past Accepting new patients
Ben Archer Health Center Past Accepting new patients

Organizations & group practices 3

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1679559348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "505-267-3088",
            "fax_number": "505-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 1ST ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945514912",
            "telephone_number": "650-580-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DD57591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore, CA

Sources for this page

Verify at the official NPI Registry.