Provider Demographics
NPI:1972688869
Name:LOPEZ, EMILIANA ESTHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILIANA
Middle Name:ESTHER
Last Name: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 1:2100 WEBSTER ST
Mailing Address - Street 2:SUITE NUMBER 325
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2378
Mailing Address - Country:US
Mailing Address - Phone:415-923-3034
Mailing Address - Fax:415-921-1051
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:SUITE NUMBER 325
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2378
Practice Address - Country:US
Practice Address - Phone:415-923-3034
Practice Address - Fax:415-921-1051
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice