Provider Demographics
NPI:1669211678
Name:DURAN LOPEZ, RAMON (DMD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:DURAN LOPEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SAWYER DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6810
Mailing Address - Country:US
Mailing Address - Phone:703-717-2469
Mailing Address - Fax:
Practice Address - Street 1:230 MARKET ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:VA
Practice Address - Zip Code:24127-6080
Practice Address - Country:US
Practice Address - Phone:540-864-5556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418879122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist