Organization Active NPI

Dr. Juan G. Lopez DMD DDS PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Charlotte, NC
National Provider Identifier
1831303429
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
7223 Issued in NC
Legal business name
DR. JUAN G. LOPEZ DMD DDS PA
Practice address
1711 Montford Dr
Charlotte, NC 28209-3721
Phone
(704) 523-7301
Fax
(704) 525-7138
NPI assigned
May 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Catalina Balcero
Title
Office Manager
Phone
(704) 523-7301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 7223 NC Primary

Addresses

Primary practice location

1711 Montford Dr
Charlotte, NC 28209-3721

Mailing address

1711 Montford Dr
Charlotte, NC 28209-3721

National Provider Directory

National Provider Directory

Locations

1711 Montford Dr
Charlotte, NC 28209
Phone (704) 523-7301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831303429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 MONTFORD DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 MONTFORD DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093721",
            "telephone_number": "704-523-7301",
            "fax_number": "704-525-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JUAN G. LOPEZ DMD DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALCERO",
        "authorized_official_first_name": "CATALINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-523-7301",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "7223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.