Marisa Ann Lopez, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12699 Issued in NC

Practice address

11835 Southmore Dr Ste 201
Charlotte, NC 28277-4820

Phone

(973) 941-2614

NPI assigned

Mar 12, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1972844264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 PANCAKE HOLLOW DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 SOUTHMORE DR STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774820",
            "telephone_number": "973-941-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "12699",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "0581951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Isabel Lopez, MA, BCBA, LBA
• Christina Lopez, LCSW
• Elizabeth Lopez, FNP-C
• Evelyn Lopez, MA, LCMHCA, NCC
• Leticia M Lopez
• Richard Patrick Lopez, DO
• Robert R Lopez, MD
• Loquitur Care Solutions LLC
• Xang Lor, FNP
• Frank E Lorch IV, MD

• Pediatric Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.