Provider Demographics
NPI:1710273925
Name:VERA-LOPEZ, KARINA (DDS)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:VERA-LOPEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4391 RIDGEWOOD CENTER DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5399
Mailing Address - Country:US
Mailing Address - Phone:703-590-4666
Mailing Address - Fax:703-897-1526
Practice Address - Street 1:4391 RIDGEWOOD CENTER DR
Practice Address - Street 2:SUITE C
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5399
Practice Address - Country:US
Practice Address - Phone:703-590-4666
Practice Address - Fax:703-897-1526
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014132161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice