IndividualActive
Diana Lopez
NPI 1821739749 · Prosthodontics · Bloomington, IL
Provider details
- NPI number
- 1821739749
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 019036011 (IL)
Practice location
2111 E Oakland Ave Ste D
Bloomington, IL 61701-5783
Phone: (309) 663-6564
Mailing address
2111 E Oakland Ave Ste D
Bloomington, IL 61701-5783
Registry dates
- Enumerated
- 2022-04-05
- Last updated
- 2025-08-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.