Provider Demographics
NPI:1063259828
Name:LOZANO LOPEZ, DIXIE (DDS)
Entity type:Individual
Prefix:
First Name:DIXIE
Middle Name:
Last Name:LOZANO 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 1:1001 ENGLISH RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:AR
Mailing Address - Zip Code:72079
Mailing Address - Country:US
Mailing Address - Phone:870-543-9292
Mailing Address - Fax:
Practice Address - Street 1:3721 S OLIVE ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6756
Practice Address - Country:US
Practice Address - Phone:870-541-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR47711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice