Active NPI
Ana Melissa Lopez, DMD
- Pediatric Dentistry
- Walnut Creek, CA
National Provider Identifier
1740390285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 61988
- Practice address
- 520 Lennon LN Ste a
Walnut Creek, CA 94598-2415 - Phone
- (925) 930-9390
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-025964 | IL | |
| Pediatric Dentistry | 1223P0221X | 021-002145 | IL | |
| Pediatric Dentistry | 1223P0221X | 61988 | CA | Primary |
Addresses
Primary practice location
520 Lennon LN Ste a
Walnut Creek, CA 94598-2415
Mailing address
520 Lennon LN Ste a
Walnut Creek, CA 94598-2415
Phone (925) 930-9390
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 |
|---|---|---|---|
| 019-025964 | IL | MD | Dentist |
| 021-002145 | IL | MD | Pediatric Dentist |
| 61988 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639353600000",
"number": "1740390285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 LENNON LN STE A",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982415",
"telephone_number": "925-930-9390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 LENNON LN STE A",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982415",
"telephone_number": "925-930-9390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "ANA",
"middle_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2021-12-13",
"certification_date": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-025964",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021-002145",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "61988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.