Provider Demographics
NPI:1609278076
Name:LOPEZ, JAVIER H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:H
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 C ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-1719
Mailing Address - Country:US
Mailing Address - Phone:925-757-4700
Mailing Address - Fax:925-756-7975
Practice Address - Street 1:800 C ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1719
Practice Address - Country:US
Practice Address - Phone:925-757-4700
Practice Address - Fax:925-756-7975
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA639501223G0001X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Yes1223G0001XDental ProvidersDentistGeneral Practice