Active NPI
Melvin Lopez, DMD
- Dentist
- Palatka, FL
National Provider Identifier
1689081242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN20873
- Practice address
- 2503 President St
Palatka, FL 32177-5433 - Phone
- (386) 328-7638
- Fax
- (386) 328-9644
- NPI assigned
- Jul 16, 2014
- Last updated
- Jun 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN20873 | FL | Primary |
| General Practice Dentistry | 1223G0001X | DN20873 | FL |
Addresses
Primary practice location
2503 President St
Palatka, FL 32177-5433
Mailing address
2503 President St
Palatka, FL 32177-5433
Phone (386) 328-7638
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015271300 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN20873 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Health Care, Inc. | Past | Accepting new patients | |
| Rural Health Care, Inc. | Past | Accepting new patients |
Interoperability endpoints
- melvin.lopez.p1@direct.azahealth.nextgenshare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Aza Health
- Federally Qualified Health Center (FQHC)
- Daytona Beach, FL
- NPI 1891227179
-
dba Aza Health
- Federally Qualified Health Center (FQHC)
- Palatka, FL
- NPI 1891762613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1689081242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2503 PRESIDENT ST",
"city": "PALATKA",
"state": "FL",
"postal_code": "321775433",
"telephone_number": "386-328-7638",
"fax_number": "386-328-9644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2503 PRESIDENT ST",
"city": "PALATKA",
"state": "FL",
"postal_code": "321775433",
"telephone_number": "386-328-7638",
"fax_number": "386-328-9644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MELVIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-16",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN20873",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN20873",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "015271300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palatka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.