Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1821739749 Individual Practitioner Female Practitioner

Diana Lopez

Dentist - Prosthodontics • Bloomington, IL

Professional Overview & Biography Verified Profile Summary

Diana Lopez is a registered healthcare professional specializing in Dentist - Prosthodontics in Bloomington, IL. Practice services are available at 2111 E OAKLAND AVE STE D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2111 E Oakland Ave Ste D

Bloomington, IL 617015783

Telephone 3096636564
Associated Practice Facility / Clinic
🏢 Solo Dental Group Pllc Facility NPI 1689562373

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Prosthodontics in Bloomington, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Bloomington, IL (81 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-08-14
Dentist - Prosthodontics Primary Specialty

NUCC Taxonomy Code: 1223P0700X

State License IL 021003464

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

Dentist

NUCC Taxonomy Code: 122300000X

State License IL 019036011

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Dr. Mark Burgess , DMD

Dentist - General Practice

NPI 1154492593

Doctor of Dental Medicine

Doctor of Dental Medicine

Grace Christianson

Dental Hygienist

NPI 1689500357
Kimberly Matthews

Dental Hygienist

NPI 1861328478
NPI 1891041331

Doctor of Dental Medicine

Julia Cash , RDH

Dental Hygienist

NPI 1902722317

Registered Dental Hygienist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location June 24, 2025

Registered at 2111 E OAKLAND AVE STE D, BLOOMINGTON, IL 617015783 (Tel: 3096636564)

📍
Updated Business Mailing Address June 24, 2025

Registered at 2111 E OAKLAND AVE STE D, BLOOMINGTON, IL 617015783 (Tel: 3096636564)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2025

Dentist (License #019036011 in IL)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2022

Dentist (License #DN1859349 in MA)

NPI Profile Active April 05, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location April 05, 2022

Registered at 188 LONGWOOD AVE, BOSTON, MA 021155888 (Tel: 6174321434)

📍
Updated Business Mailing Address April 05, 2022

Registered at 188 LONGWOOD AVE, BOSTON, MA 021155888 (Tel: 6174321434)

👤
Provider Name / Credentials Updated April 05, 2022

Recorded as DIANA LOPEZ

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 05, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 05, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1821739749
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 05, 2022
Last Update: August 14, 2025
Sole Proprietor: No

Mailing Address

2111 E Oakland Ave Ste D

Bloomington, IL 617015783

Phone: 3096636564

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.